ic  last  date  stamped  below 

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THE   HEALTHY  BABY 


THE  MACMILLAN  COMPANY 

NEW  YORK    •    BOSTON  •    CHICAGO 
DALLAS   •    SAN    FRANCISCO 

MACMILLAN  &  CO.,  LIMITED 

LONDON   •    BOMBAY   •    CALCUTTA 
MELBOURNE 

THE  MACMILLAN  CO.  OF  CANADA,  LTD. 

TORONTO 


THE  HEALTHY  BABY 

THE  CARE  AND  FEEDING  OF  INFANTS 
IN  SICKNESS  AND  IN  HEALTH 


BY 

ROGER   H.   DENNETT,  M.D. 

INSTRUCTOR    IN    DISEASES    OF    CHILDREN    IN    THE    NEW 

YORK  POST-GRADUATE  MEDICAL  SCHOOL;  ASSISTANT 

ATTENDING  PHYSICIAN  TO  THE  BABIES*  WARDS  IN 

THE      NEW     YORK      POST-GRADUATE     HOSPITAL  J 

CHIEF     OF     CLINIC    IN    THE    POST-GRADUATE 

DISPENSARY  FOR  CHILDREN  ;    FELLOW  OF 

THE  NEW  YORK  ACADEMY  OF  MEDICINE 


fforfe 
THE  MACMILLAN  COMPANY 

1920 

[ 

All  rights  reserved 


COPYRIGHT,  1912, 
BY  THE   MACMILLAN  COMPANY. 


Set  up  and  electrotyped.     Published  May,  191*. 


Xortooob  \Bitss 

J.  8.  Cashing  Co.  —  Berwick  <fc  Smith  Co. 
Norwood,  Mass.,  U.S.A. 


tl 


Defctcatfon 

TO  ALL   CHILDREN   AND   ESPECIALLY 
TO   MY   OWN   CHILDREN 

ALICE,  NANCY,  AND  SALLY 

WHO    HAVE    BEEN    THE    CHIEF    INSPIRATION 

IN    MY   STUDY   OF    CHILD   WELFARE 

THIS   BOOK  IS   DEDICATED 


PREFACE 

THE  author's  chief  reason  for  writing  this 
book  was  to  make  clear  to  the  mother  just  how 
to  do  best  the  ordinary  everyday  things  that 
every  mother  has  to  do  for  her  child.  He 
believes  that  there  is  a  definite  need  for  a  book, 
which  will  describe  in  the  minutest  detail  the 
daily  care  of  the  baby.  The  description  or 
treatment  of  any  but  the  simplest  ailments  has 
purposely  been  left  out,  because  a  book  of  this 
sort  which  attempts  in  any  way  to  describe  dis- 
eases, does  more  harm  than  it  does  good.  A 
well-trained  physician  or  a  specialist  in  chil- 
dren's diseases  finds  it  difficult  enough  at  times 
to  diagnose  the  different  affections,  and  it  only 
confuses  the  mother  or  nurse  to  describe  the 
different  diseases  to  her. 

The  chapter  on  feeding  has  purposely  been 
cut  down,  and  all  complicated  formulas  omitted. 
Probably  more  harm  has  been  done  than  can 
possibly  be  estimated,  by  giving  to  mothers 
sets  of  complicated  formulae  which  she  tries  to 
vii 


VU1  PREFACE 

use  herself.  She  experiments  first  with  one 
and  then  with  another  until  she  ruins  her 
baby's  digestion.  I  describe  the  simplest  kinds 
of  milk,  water,  and  sugar  mixtures,  and  if  these 
do  not  agree  with  the  baby,  I  would  most  em- 
phatically recommend  seeking  the  physician's 
help.  Feeding  bottle  babies  is  one  of  the  most 
difficult  things  we  have  to  deal  with. 

121  EAST  38TH  STREET, 
NEW  YORK. 


CONTENTS 

INTRODUCTORY       


PART   I 
DEVELOPMENT   AND   THE    BODILY   FUNCTIONS 

DEVELOPMENT  OF  BODY  AND  MIND      ....        3 
—  SLEEP    .         .         .        ,        *        .  .         .        .12 

CRYING 17 

APPETITE 20 

VOMITING 24 

THE  BOWELS 28 

PART  II 
HYGIENE   AND  TRAINING 

<r  CLOTHING       . 41 

>    THE  BATH 49 

FRESH  AIR .53 

f    EXERCISE       ...                58 

TRAINING  AND  DISCIPLINE   .         .        »        .         .        .  62 

DAILY  ROUTINE     .                 68 

HABITS  .        .        , 71 

• 


X  CONTENTS 

PA11T    III 
COMMON   AILMENTS 

PAGE 

THE  SICK  ROOM 79 

CONTAGIOUS  DISEASES  ......         .81 

FEVER 90 

COLDS  AND  COUGHS      .        .  .        .  .92 

CROUP .        .95 

CONVULSIONS 98 

ACCIDENTS 101 

BED- WETTING        ........     109 

WORMS .113 

THE  NERVOUS  CHILD-. 115 

PART  IV 

CARE   OF   THE   SPECIAL   ORGANS 

THE  THROAT 121 

THE  TEETH 124 

THE  EYES 130 

THE  EARS .132 

THE  SKIN      ....;....  134 

THE  HAIR 137 

THE  GENITAL  ORGANS 139 

PART    V 
FEEDING  AND   DIET 

BREAST  FEEDING 147 

WEANING 155 


CONTENTS  XI 

PAGE 

THE  BOTTLE  AND  NIPPLES 162 

MILK 165 

MIXING  AND  CARE  OF  THE  FOOD         ....  169 

THE  COMPOSITION  AND  STRENGTH  OF  THE  FOOD         .  172 

FOOD  FOR  TRAVELING 182 

THE  DIET  AFTER  THE  FIRST  YEAS     ....  183 

DIET  FOR  SICK  CHILDREN 197 

WATER 201 

PART    VI 
LISTS  AND  TABLES 

LIST  FOR  EXPECTANT  MOTHER     .....  207 

FOR  THE  BABY'S  BASKET 207 

CLOTHES 208 

TABLE  OF  HEIGHT 208 

TABLE  OF  WEIGHT       .......  209 

NUMBER  OF  PULSE  BEATS  PER  MINUTE       .         .         .  209 

NUMBER  OF  RESPIRATIONS  PER  MINUTE      .         .        .  209 

TABLE  OF  POISONS  AND  ANTIDOTES     ....  210 

MEMORANDUM        ....                 ...  213 


INTRODUCTORY 

THE   average   mother   has   a  keen  sense  of  The  Duties 
duty  toward  her  children,  and  it  is   only  her  hood1"* 
lack   of    knowledge,    when   this   duty   is   first 
thrust  upon  her,  that  prevents  her  from  bring- 
ing up  the  baby  in  model  fashion.     In  these 
days  of   artificial   living,    it   requires  constant 
watchfulness  and  hard  work  and  devotion   to 
carry  the  child  through  infancy  and  childhood 
in  such  a  manner  that  he  may  reach  adult  life  Success  in 
sound  in  body  and  in  mind.     The  more  normal  dependent 


the  individual  the  better  chance  he  has  to  sue-  up°na? 

mal  Start. 

ceed  in  later  life.  The  vast  majority  of  abnor- 
malities start  in  the  early  years.  The  baby 
whose  digestion  is  ruined  by  wrong  feeding 
may  grow  up  to  be  a  dyspeptic  adult,  who  can 
neither  do  his  share  of  work  in  the  world  nor 
receive  his  share  of  pleasure  out  of  it.  The 
child  whose  adenoids  are  neglected  not  only 
may  have  colds  and  catarrh  for  the  rest  of  his 
life,  but  he  is  less  alert  mentally  and  conse- 
quently backward  in  his  studies.  Lack  of  suc- 
xiii 


XIV  INTRODUCTORY 

cess  in  life  is  due,  in  many  cases,  to  physical 
defects  that  might  have  been  avoided  by  an 
intelligent  bringing  up. 

The  bowels,  the  skin,  the  hair,  the  teeth,  the 
habits,  and  all  the  functions,  therefore,  should 
be  carefully  studied. 

We  should  send  our  children  out  in  life 
equipped  with  the  right  kind  of  body,  as  well 
as  the  right  kind  of  mind.  I  realize  fully  that 
a  mother  has  other  duties  than  these  toward 
her  children.  However,  the  mother  who  takes 
care  of  her  own  children  will  find  it  less  work 
to  do  so  in  the  proper  modern  way  than  did  the 
mother  of  former  generations,  who  carried  the 
baby  about  in  her  arms  while  at  work  or  rocked 
the  cradle  while  she  sewed.  The  mother  who 
employs  a  nurse  should  devote  some  of  her  time 
to  the  baby  and  should  supervise  all  its  care. 
To  do  this,  she  must  know  how.  It  is  bad  pol- 
icy to  have  a  poor  nurse  and  a  good  cook  ;  if  a 
choice  must  be  made  between  the  two,  the 
nurse  should  have  the  superior  intelligence. 

There  are  constantly  being  brought  to  me 
children  of  all  ages  who  are  thin  and  flabby,  or 
who  perhaps  cry  a  good  deal,  or  have  one  or 
more  signs  of  ill  health  which  the  mother  either 
has  not  observed  or,  observing,  has  thought  were 


INTRODUCTORY  XV 

either  common  to  all  babies,  or  peculiar  to  her  Signs  of 

Health, 
own.     It  would,  therefore,  be  well  first  to  list 

the  things  that  denote  good  health,  and  later 
to  consider  each  in  detail.  Every  well  child  of 
any  age  should  :  — 

(1)  Show  progressive  development  of  body 
and  mind. 

(2)  Gain   constantly   in   weight,   and    have 
solid  flesh  and  well-shaped  bones. 

(3)  Have  the  proper  amount  of  restful  sleep. 

(4)  Cry  but  little. 

(5)  Have  a  good  appetite. 

(6)  Have  well-regulated  bowels. 

(7)  Have  no  vomiting  or  gas. 

(8)  Have  a  clear  skin  and  good  color. 

If  the  baby  does  not  come  up  to  this  stand- 
ard, we  may  know  that  something  is  wrong,  and 
we  must  set  ourselves  the  task  of  finding  out 
what  that  thing  is.  It  is  much  easier  to  pre- 
vent an  illness  than  it  is  to  cure  one.  With 
this  fact  in  mind  this  book  is  written. 


PART  I 

DEVELOPMENT  AND   THE    BODILY 
FUNCTIONS 


THE  HEALTHY  BABY 

THE   CARE   AND  FEEDING  OF  INFANTS 
IN   SICKNESS  AND  IN   HEALTH 

DEVELOPMENT  OF  BODY   AND  MIND 

THE  gradual  awakening  of  the  various 
senses  and  the  progressive  development  of 
the  common  acts  and  functions  of  life  have 
been  the  same,  generation  after  generation, 
since  civilization  began.  Each  baby  is  much 
like  his  predecessor,  although  we  usually 
believe  our  baby  to  be  a  little  bit  superior  to 
the  average.  Averages  are  hard  to  strike,  importance 
but  it  is  important  to  have  a  standard  so  that  NormaT*  * 
we  may  be  warned  early  of  any  deviation  Standard- 
from  the  normal.  We  can  correct  such  devia- 
tions far  more  easily  in  the  beginning.  At 
the  same  time  no  "forcing"  should  be  used 
to  make  baby  come  up  to  our  standard,  and 
the  nervous  mother  should  not  be  in  a  con- 
stant state  of  worry  for  fear  her  baby  is  back- 
ward or  deficient. 

The  first  three  months  of  his  life,  baby 
doesn't    notice    much    of    anything.     Loud 
3 


4  THE    HEALTHY   BABY 

noises  disturb  him,  so  we  know  that  he  hears. 
A  strong  light  makes  him  blink,  or  close  his 
eyes,  so  we  know  that  he  has  some  sight; 
in  fact,  often  his  eyes  will  follow  a  light  the 
Natural  De-  se.cond  or  third  week.  He  is  three  or  four 
during  the  months  old  before  he  discovers  his  hands 
and  begins  to  PlaY  witn  them.  About  this 
time  he  learns  to  smile  when  we  chuck  him 
under  the  chin,  or  make  clicking  noises  with 
our  lips  in  the  familiar  manner  in  which  we 
are  apt  to  address  him.  He  can  say  goo! 
goo!  and  make  delightful  little  noises  with 
his  throat,  which  grandma  declares  are 
intended  for  her  name.  He  holds  his  head 
erect  at  four  months,  and  sits  alone  with  a 
pillow  at  his  back  at  six  months ;  at  this  age 
also  he  knows  his  mother  and  is  apt  to  dislike 
strangers.  He  holds  things  in  his  hands 
and  puts  them  to  his  mouth,  and  now,  most 
wonderful  of  all,  the  first  tooth  may  appear. 
At  eight  or  nine  months  he  sits  upon  the  floor 
alone  and  possibly  learns  to  creep.  Some 
babies  never  creep,  however. 

Up  to  this  time  there  is  not  much  danger 
of  urging  him  too  fast.  Of  course,  it  is  not 
well  to  play  with  him  too  much  nor  to  allow 


DEVELOPMENT   OF   BODY  AND   MIND          5 

him    to    become    excited.      Mother,  —  and 
Father,   too,  —  wants   to   enjoy    him  while 
he  is  so  irresistible.     However,  he  should  not 
be  made  to  show  off  and  do  tricks  upon  every  The  Danger 
occasion,  and  he  should  not  be  trotted  out  to  °£e  Baby1"8 
be  played  with  and  handed  about  for  the  Off-" 
admiration  of  loving  friends.     He  should  not 
be  taken  to  parties  or  calling,  nor  do  unneces- 
sary traveling. 

When  it  comes  to  walking,  he  must  bide 
his  own  time.  He  will  walk  when  his  bones 
and  muscles  are  strong  enough,  and  if  he 
has  been  properly  fed,  we  need  not  fear 
bowlegs  or  knock-knee  when  he  starts  to 
walk  of  his  own  accord,  whatever  the  age. 
As  a  matter  of  fact,  the  age  of  walking  The  Age  of 

.    ,,  A  j.         •  Walking. 

is  a  very  variable  one.  At  nine  or  ten 
months  baby  first  realizes  that  his  feet  are 
meant  to  stand  upon,  and  if  at  a  year 
he  is  able  to  walk  with  support,  he  is  doing 
well.  At  eighteen  months  if  he  does  not  walk 
by  himself,  he  may  be  considered  backward 
and  the  cause  should  be  looked  into.  Walk- 
ing is,  of  course,  a  mental  as  well  as  physical 
process.  Baby  is  bound  to  have  some  tum- 
bles, but  he  learns  to  take  them  philosophi- 


THE   HEALTHY   BABY 


Delayed 
Talking. 


cally.  In  order  that  his  walking  may  be  un- 
hampered, his  diapers  should  be  discarded 
for  drawers  soon  after  he  is  a  year  old,  for 
if  he  has  been  properly  trained,  he  will  not 
need  them.  The  carriage  of  the  body  should 
be  erect,  and  as  the  child  grows  older,  faulty 
postures  while  standing  or  sitting  should  be 
guarded  against. 

The  power  of  speech  is  baby's  next  ac- 
quisition. At  a  year  he  can  say  Mama  and 
Papa.  Gradually  he  adds  a  few  more  proper 
nouns  to  his  vocabulary,  then  the  names  of 
familiar  objects ;  laboriously  he  joins  these 
with  verbs,  and  finally,  at  two  years,  he  has 
learned  to  express  thoughts  in  simple  lan- 
guage. Children  who  talk  readily  should 
not  be  stimulated  too  much. 

Some  children  are  very  late  in  talking,  par- 
ticularly if  they  are  not  encouraged.  They 
make  signs  or  point  to  the  object  of  their 
desires,  and  find  it  easier  than  learning  to 
talk.  This  is  pure  indolence  on  their  part 
and  incidentally  on  the  part  of  the  mother. 
Adenoids  are  a  frequent  cause  of  delayed 
talking.  If  a  child  does  not  talk  at  two  or 
two  and  a  half  years  of  age,  deafness  or  men- 


DEVELOPMENT   OF   BODY  AND   MIND  7 

tal  deficiency  should  at  least  be  considered 
as  a  possible  cause  of  his  backwardness. 

Lisping,  stuttering,  and  defective  speech  of  Defective 
all  sorts,  such  as  using  one  consonant  for  the  peec  ' 
other,  should  be  nipped  in  the  bud.  Such 
defects  are  overcome  by  constantly  requiring 
the  child  to  pronounce  his  words  correctly. 
He  is  made  to  repeat  the  word  each  time  he 
makes  his  mistake,  which,  of  course,  takes  a 
lot  of  time  and  patience.  I  occasionally  see 
children  of  four  or  five  years  of  age  who  talk 
so  badly  that  no  one  but  the  parents  can 
understand  what  they  say.  Some  children 
with  defective  speech  need  a  special  training, 
as  well  as  an  examination  of  the  various 
organs  of  speech  to  make  sure  that  these  are 
not  defective.  In  most  of  the  children  in 
whom  I  notice  defective  speech,  I  find  that 
laziness  is  the  reason  for  it. 

The  mental  development  of  the  child  goes 
forward  by  leaps  and  bounds.  Every  day 
he  learns  something  new,  and  his  thoughts 
should  be  guided  in  the  proper  channels. 
He  should  be  allowed  all  the  independence  of 
thought  and  action  that  is  compatible  with 
good  discipline,  in  order  that  he  may  ac- 


8  THE   HEALTHY   BABY 

stimu-  quire  originality  and  initiative.  It  is  most 
^child's  difficult  to  find  the  mean  between  constant 
Activit*1  narassmS  and  scolding  and  "don'ts, "  and 
spoiling  the  child  by  allowing  him  to  have 
his  own  way  in  all  things.  Lest  he  become 
a  laggard  in  the  world,  his  time  should  al- 
ways be  occupied,  particularly  at  four  or  five 
years  of  age  when  the  simple  entertainments 
of  babyhood  cease  to  interest  him.  For 
this  reason,  I  approve  of  kindergarten  for 
children  of  the  proper  age  and  robust  health, 
provided  it  does  not  make  them  nervous  or 
delicate.  They  should,  however,  be  taught  to 
entertain  themselves  some  hours  of  the  day. 
Develop-  While  the  mind  has  been  developing,  the 
the^Body.  body  should  have  kept  pace  with  it.  Not 
only  has  the  weight  been  steadily  increasing, 
but  the  body  has  been  lengthening  out.  It 
is  of  very  little  importance  to  keep  track  of 
the  height,  but  a  table  will  be  appended  for 
reference.  The  extremities  should  grow  in 
proportion  to  the  trunk  and  be  well  shaped. 
The  head  should  be  round  and  symmetrical. 
Any  one-sidedness  of  the  head  usually  denotes 
an  inclination  to  soft  bones.  Especial  care 
should  be  taken  to  lay  the  infant  first  on 


DEVELOPMENT  OF   BODY   AND   MIND          9 

one  side  then  upon  the  other.  The  fonta-  TheFon- 
nel,  or  bony  opening  in  the  top  of  the  head, 
is  worthy  of  the  mother's  observation. 
Widely  open  at  birth,  it  begins  to  grow  smaller 
during  the  end  of  the  first  year  and  is  entirely 
closed  at  eighteen  months  or  two  years. 

The  teeth  should  come  along  on  schedule 
time,  be  well  formed,  and  not  become  carious. 
(See  " Teeth.")  The  chest  should  be  broad 
and  symmetrical.  The  abdomen  is  naturally  The  Abdo- 
protuberant  in  early  childhood,  especially 
if  the  child  is  fat.  It  is  firm  and  hard  like 
the  other  muscles  of  the  body.  When  the 
baby  is  sick,  mothers  often  discover  for  the 
first  time  that  the  abdomen  becomes  hard 
while  he  is  crying.  It  should  be  so,  but  the 
observation  is  made  for  the  first  time  be- 
cause she  is  worried.  If  the  navel  protrudes 
while  the  child  is  crying,  it  should  be  attended 
to  at  or  ;e. 

Baby  has  come  into  this  world  a  very  small  Babies 
bit  of  humanity.     Every  week  he  must  grow  Fat. 
if  he  wants  to  be  a  man.     Not  only  does  he 
grow  in  length,  but  it  is  his  nature  to  be  round 
and  plump,  so  that  he  must  work  hard  if  he 
expects  to  keep  fat  while  he  is  growing  tall. 


10  THE   HEALTHY   BABY 

HOW  much  How  many  times  baby's  mother  has  said 
>UBaby  to  me,  "Baby  is  not  fat,  but  he  is  like  his 
Weigh?  father  in  that."  And  then  I  explain  that  all 
well  babies  are  fat.  When  baby  is  born,  he 
weighs  about  seven  pounds.  He  loses  a  few 
ounces  the  first  few  days  and  then  he  starts 
upon  his  journey.  Each  week  he  gains  six 
ounces,  sometimes  more,  sometimes  less, 
until  he  is  six  months  old,  when  he  has 
doubled  his  birth  weight ;  after  that,  he  gains 
more  slowly,  say  four  ounces  a  week  until, 
when  he  is  a  year  old,  he  has  trebled  his  birth 
weight.  Then  he  slows  down  still  more, 
gaining  about  five  pounds  each  year  until  he 
is  eight  or  nine  years  old.  Of  course,  even 
well  babies  can't  keep  to  the  schedule  all  the 
time.  If  baby  falls  by  the  wayside  and 
makes  no  gain  for  a  week  or  two  occasionally, 
but  is  otherwise  well,  do  not  worry  about 
it  —  he  is  only  imitating  his  pre>  ecessors. 
Fat  Babies  However,  his  flesh  must  be  solid  and  his 
D°Heaithy!  muscles  firm.  Some  fat  babies  are  flabby 
because  they  have  had  food  that  has  made 
them  fat  but  has  not  built  up  the  muscles 
and  bones.  These  are  never  strong  babies, 
and  a  serious  illness  is  apt  to  go  hard  with 


DEVELOPMENT   OF   BODY  AND   MIND        11 

them.  Other  babies  have  misshapen  heads 
or  chests,  or  large  wrist  bones,  and  these,  too, 
are  caused  by  wrong  food. 

Even  a  novice  can  readily  see  the  reason  Keeping 
for  keeping  watch  of  the  baby's  weight.  It  J 
is  the  chief  indicator  of  his  normal  progress. 
It  is  not  well  to  weigh  the  healthy  baby  more 
than  once  a  week,  lest  we  become  worried 
unnecessarily.  A  chart  or  other  record  of 
weight  may  be  kept,  but  we  must  avoid  over- 
feeding just  to  make  a  good  showing  on  the 
chart.  The  baby  is  stripped  before  his  bath 
and  before  a  feeding  and  put  upon  the  scales. 
The  best  scales  are  the  ordinary  grocer's  The  Best 
scales  with  the  bar  divided  in  ounces,  along  use.68 
which  slides  the  hanging  weights,  and  pro- 
vided with  additional  weights  up  to  twenty- 
five  .pounds.  There  should  be  a  flat  plat- 
form at  one  end,  upon  which  is  placed  the 
scoop  that  comes  with  the  scales,  or  a  basket 
made  especially  for  weighing  babies,  and  pur- 
chasable at  any  department  or  hardware  store. 
The  dial  or  spring  scales,  such  as  are  ordinarily 
sold  for  weighing  babies,  are  useless.  When 

the  baby  kicks,  the  dial  bobs  about  and  makes 

* 

it  difficult  to  get  an  accurate  reading. 


12  THE   HEALTHY   BABY 

After  the  first  year  and  especially  during 
the  second  year,  there  should  be  a  weighing 
once  in  two  or  three  months  to  enable  us  to 
keep  an  eye  on  the  nutrition. 

SLEEP 

The  Early  IT  has  been  truly  said  that  a  baby's  early 
life  is  made  up  of  sleeping  and  eating.  As 
soon  as  the  excitement  of  his  entrance  into 
this  world  subsides,  he  promptly  goes  to 
sleep.  When  hunger  awakens  him,  he  takes 
his  food  and  as  soon  as  he  has  eaten  enough, 
he  goes  to  sleep  again.  This  monotonous 
existence  is  interrupted  usually  twice  a  day, 
once  when  he  has  his  bath  and  once  when  he 
indulges  in  a  little  exercise,  say  of  an  hour 
or  so,  which  he  takes  in  the  form  of  crying, 
and  to  which  he  is  entitled.  Thus  he  sleeps 
twenty-two  hours  out  of  every  twenty-four 
during  the  first  two  or  three  months.  And 

"Shall  we  now  comes  the  question,  Shall  we  awaken 
him  for  his  food?  The  answer  (with  res- 
ervations) is  "No."  I  am  aware  that  au- 
thorities have  long  told  us  to  awaken  our 
babies  every  two  hours  to  feed  them,  and  I 
am  also  sure  that  this  rule  has  caused  many 


SLEEP  13 

a  pain  and  sleepless  hour,  and  eventually 
a  ruined  digestion.  The  healthy,  well-fed 

babe,  when  the  food  is  right,  awakens  after 

« 

three  hours  sleep.  Occasionally  he  awakens 
in  two  and  one  half,  or  even  two  hours,  when 
he  should  be  persuaded  to  wait  another  hour, 
or  half  hour,  as  a  matter  of  discipline  in  regu- 
larity. If  this  occurs  too  often,  we  may  as- 
sume that  his  food  is  insufficient  either  in 
quantity  or  strength,  and  the  remedy  is  to 
increase  the  quantity  or  strength.  If  this 
is  impossible,  as  it  sometimes  is  with  the 
breast-fed  child,  the  two-and-one-half  or 
two-hour  intervals  should  be  adopted,  but 
no  healthy  baby  should  be  fed  oftener  than 
once  in  two  hours.  However,  occasionally 
we  see  babies  turn  night  into  day  by  awaken- 
ing at  two-  or  three-hour  intervals  during 
the  night  and  sleeping  from  four  to  six  hours 
without  eating  in  the  daytime.  These  babies 
may  be  awakened  for  their  food  in  the  day- 
time at  regular  intervals,  but  more  for  the 
comfort  of  the  mothers  or  nurses  than  for 
that  of  the  baby. 

After  the  third  month,  baby  begins  to  take  The  Q 
more  interest  in  life,  and  stays  awake  look- 


14  THE   HEALTHY   BABY 

ing  at  his  hands  or  watching  his  neighbors 
a  little  longer  each  day,  until  at  six  months 
he  sleeps  twelve  hours  at  night,  from  six  to 
six,  and  has  a  two-hour  nap  both  in  the  morn- 
ing and  in  the  afternoon.  If  he  sleeps  too 
late  in  the  afternoon,  he  won't  go  to  sleep 
promptly  at  six,  as  he  should,  so  make  the 
afternoon  nap  an  early  one,  awaking  him 
at  three.  During  the  first  half  of  the  second 
year  we  find  he  won't  take  two  naps  a  day, 
or  if  he  does,  he  won't  sleep  well  at  night,  so 
we  give  up  one  or  the  other,  preferably  the 
afternoon  nap.  One  nap  a  day  is  continued 
until  the  fourth  or  fifth  year.  The  naps, 
especially  during  the  early  months,  may  be 
Seeping  taken  out  of  doors  in  the  baby  carriage  or  on 
Doorf  the  piazza  °r  even  on  the  fire  escape  when 
this  is  the  best  we  can  afford.  It  seems  un- 
necessary to  say  that  sleeping  out  of  doors  is 
not  harmful. 

Amount  of  And  now  we  must  be  firm  with  the  rule  of 
necessary  to  bed  at  six,  for  many  temptations  come  up 
to  prevent  it.  Twelve  hours  sleep  is  the 
right  of  every  child  until  seven  years  of  age, 
ten  hours  until  ten  or  twelve  years.  Many 
a  pale,  washed-out  looking  child  of  this  age 


SLEEP  15 

owes  his  ill  health  to  lack  of  sleep.     However, 

the  elder  child  usually  regulates  the  amount 

of  sleep  himself  if  he  has  half  a   chance. 

Mothers  who  complain  that  their  children 

sleep  late  in  the  morning  allow  them  to  stay 

up  late  at  night.     Oftentimes  the  child  who 

awakens  early  in  the  morning  has  had   too 

long   a   nap  in  the  daytime.     There   is   no 

excuse   for    any    child    arousing    the    entire 

household  at  four  or  five  in  the  morni.ig,  if 

the  hours  are  carefully  regulated.     Habit  is 

an  important  factor  in  sleep.     Baby  mustn't 

be  allowed  to  go  to  sleep  with  the  nipple  in 

his   mouth.     He   should   finish   his   nursing 

and  then  be  put  in  his  own  bed,  so  that  he 

may  acquire  the  habit  of  going  to  sleep  of 

his  own  accord.     He  should  never  be  rocked 

to  sleep,  or  sleep  in  a  lighted  room,  or  have 

any  one  remain  with  him  while  he  is  going 

to  sleep.     The  mother  should  not  form  the 

habit  of  going  into  his  room  whenever  he  Babies  who 

cries.     I  have  known  mothers  whose  custom 

it  was  to  spend  the  whole  evening  listening 

for  a  sound  from  the  nursery.     Baby  cries 

and  mother  runs  to  him  and  stays  with  him 

until  he  goes  to  sleep  again.     This  occurs 


16  THE   HEALTHY   BAB? 

more  and  more  frequently  until  the  child  has 
become  a  restless  sleeper  and  often  gets  so 
he  awakens  every  hour  or  two  throughout 
the  night.  The  remedy  is  to  stay  out  of 
the  baby's  room  after  he  is  once  made  com- 
fortable for  the  night,  and  after  we  are  sure 
that  nothing  is  wrong.  If  he  has  already 
formed  such  a  habit,  we  must  let  him  "cry 
it  out"  for  a  few  nights  and  he  will  soon 
understand  that  he  must  sleep  after  he  has 
been  put  to  bed.  Another  bad  habit  is 
established  when  we  tiptoe  about  the  house 
and  speak  in  whispers  lest  we  wake  the  baby. 
It  is  far  better  for  him  to  learn  to  sleep 
through  the  ordinary  noises  that  legitimately 
exist  in  the  household  than  it  is  to  accustom 
him  to  absolute  quiet,  for  then  even  a  slight 
noise  awakens  him.  At  the  same  time  the 
adult  members  of  the  family  rarely  enjoy  a 
normal  evening.  Still  another  bad  habit  is 
established  when  baby  is  pushed  about  in 
the  baby  carriage  in  order  to  get  him  to  sleep. 
This  is,  of  course,  the  same  as  rocking  him 
Every  to  sleep.  Baby  should  sleep  alone,  in  fact 
should  a  child  of  any  age  ought  to  have  a  separate 
Alone!  bed  where  it  is  possible.  It  is  best  to  have  a 


CRYING  17 

firm  hair  mattress  and  no  pillow.  In  the 
early  months  he  should  be  laid  first  upon 
one  side  then  upon  the  other. 

The  windows  should  be  wide  open  top  Fresh  Air  at 
and  bottom,  winter  and  summer,  after  the 
first  few  weeks,  although  it  is  well  to  avoid 
a  direct  draught.  Warm  night  clothing, 
such  as  I  will  describe  when  I  speak  of 
"Clothing,"  is,  of  course,  necessary. 

At  any  age  if  the  sleep  is  not  restful  and 
continuous,  something  is  wrong  and  the 
physician  should  be  consulted. 

CRYING 

CAN  you  tell  what  is  the  matter  with  baby 
when  he  cries  ?  Usually  a  children's  special- 
ist can,  but  that  is  something  I  cannot  im- 
part to  you.  When  you  have  heard  him  cry 
many  times,  you  will  know.  There  is  the 
fretful  cry  of  the  baby  who  is  discontented  The  Mean- 
with  his  lot.  He  is  wet,  or  he  is  hot,  or  un- 


comfortably  dressed,  or  hungry.     There   is  Cry< 
the  angry    cry,  the  outburst  of  disappoint- 
ment when  he  finds  this  world  is  not  the 
pleasant  place  he  thought  it  to  be,  and  which 
is  solaced  by  attention.     There  is  the  cry 


18  THE    HEALTHY   BABY 

of  pain,  the  unceasing  cry  which  no  amount 
of  attention  or  distraction  can  alleviate. 
There  is  the  hoarse  cry  of  the  child  who  has 
cried  a  great  deal,  or  the  throaty  cry  of  the 
child  suffering  with  some  throat  affection. 
There  is  the  low  moaning  cry  of  the  very  sick 
child,  which  breaks  your  heart  to  hear. 
There  is  even  the  cry  indicative  of  certain 
diseases,  such  as  the  "cephalic  cry"  of 
meningitis  and  other  brain  conditions,  and 
the  wild  night  cry  with  which  the  child  with 
bone  tuberculosis  starts  out  of  his  sleep. 
Normal  |  In  the  early  months  a  certain  amount  of 

A™ciyingf  crvmS  is  g°°d  f°r  a  baby;  it  exercises  his 
lungs  and  muscles  and  helps  the  circulation. 
As  David  Harum  says;  ^Some  fleas  is  good 
for  a  dog.  It  keeps  him  from  broodin'  on 
bein'  a  dog."  However,  one  or  two  hours 
of  crying  a  day  is  sufficient.  When  there  is 
much  more  than  that,  the  cause  should  be 
investigated. 

Hunger  or  Perhaps  the  greatest  difficulty  is  to  dis- 
tinguish between  the  cry  caused  by  hunger 
and  that  caused  by  colic,  or  indigestion. 
The  simplest  indicators  are  the  stools,  the 
amount  of  gas  expelled,  and  the  vomiting. 


CRYING  19 

If  the  stools  are  a  good  yellow  color,  smooth 
and  well  digested,  containing  no  mucus  nor 
curds,  and  if  there  is  no  vomiting  and  no 
gas  expelled,  we  may  suspect  that  the  trouble 
does  not  lie  with  the  digestive  tract.  Hun- 
ger is  more  apt  to  cause  crying  just  before 
the  feeding  is  due,  the  length  of  time  varying 
with  the  degree  of  hunger.  A  babe  very 
much  underfed  may  cry  most  of  the  time,  be- 
cause his  hunger  is  never  satisfied  even  im- 
mediately after  a  feeding. 

Baby  should  not  be  allowed  to  get  in  the  The 
habit  of  crying  if  he  is  well.  Some  mothers  crying0— 
have  become  so  bound  to  routine  that  they 
do  not  change  it  as  baby  grows  older,  and 
he  cries  more  and  more  as  the  system  ap- 
peals to  him  less  and  less.  For  instance, 
one  mother  had  adopted  the  routine  of  put- 
ting her  baby  out  of  doors  in  the  carriage 
early  in  the  morning  and  of  leaving  him  by 
himself,  and  going  to  him  only  when  it  was 
time  to  feed  or  change  him.  This  was  a 
very  proper  routine  for  the  first  months,  but 
when  he  was  seven  months  of  age,  she  came 
to  me  to  find  out  why  he  cried  so  much.  It 
was,  of  course,  because  he  was  getting  too  old 


20  THE    HEALTHY   BABY 

to  sleep  all  day  and  all  night,  too.  She  was 
making  a  fussy  baby  of  him  through  constant 
discontent  and  crying.  Older  children  also 
form  the  habit  of  crying  at  the  slightest  provo- 
cation. They  need  tactful  treatment  to  get 
them  out  of  it.  However,  habitual  crying 
is  far  more  frequently  due  to  errors  in  diet 
in  a  child  of  any  age  than  to  all  the  other 
causes  put  together.  Next  in  the  order  of 
frequency  comes  the  spoiled  child,  who  needs 
different  parents  more  than  anything  else. 

Earache  and  the  open  safety  pin  are  causes 
so  much  dwelt  upon  that  even  the  father 
can  make  that  diagnosis. 

APPETITE 

Poor  BABY  is  a  hungry  creature.  If  he  is  not, 
in  infants6  something  is  wrong.  Like  a  horse,  he  will 
always  eat.  If  he  awakens  before  his  feeding 
time,  his  first  thought  is  to  eat.  If  he 
awakens  at  night,  he  cries  until  he  is  fed. 
When  he  is  sick  and  fretful,  he  nurses  still 
oftener  (if  you  let  him).  In  his  early  weeks 
it  is  the  only  form  of  recreation  he  has.  It 
is  good  for  baby  to  be  hungry,  but,  as  with 
the  horse,  our  higher  intelligence  must,  to  a 


APPETITE  21 

certain  extent,  regulate  his  feeding  times  and 
the  food  itself  so  that  his  appetite  will  re- 
main good.  If  a  horse  gets  into  the  oat  bin, 
he  eats  until  he  is  sick.  If  baby  is  allowed 
to  eat  whenever  he  cries,  he  eats  until  he  is 
sick,  finally  loosing  his  appetite.  When  an 
infant  refuses  his  bottle  or  the  breast,  we 
know  (unless  he  has  some  definite  illness) 
that  we  have  been  feeding  him  too  often  or 
too  much,  or  that  some  element  of  the  food 
is  too  strong ;  weaken  the  food  or  lengthen 
the  intervals  until  he  is  hungry.  Nothing 
will  ruin  baby's  appetite  or  digestion  more 
quickly  than  nursing  three  or  four  times 
during  the  night,  and  frequently  breast-fed 
children  are  allowed  to  lie  at  the  breast  all 
night. 

Infants  who  are  taken  acutely  ill  usually  The  Sick 
stop  eating   at   once   of   their   own   accord.  Appetites. 
They  show  greater  wisdom  than  does   the 
mother  who  tries  to  force  the  child  to  eat 
when   his   stomach    is    in   no    condition   to 
digest   food.     This   voluntary   starvation   is 
the  very  best  thing  at  the  beginning  of  any 
illness,  especially  where  there  is  fever.     Sick 
children  are  often  thirsty,  as  well  as  restless, 


22  THE    HEALTHY   BABY 

so  they  sometimes  nurse  or  drink  milk  to 
quench  their  thirst  when  their  digestion  will 
not  take  care  of  any  nourishment. 

Of  course,  some  infants  are  too  hungry. 
They  cry  as  soon  as  the  bottle  or  breast  is 
taken  away,  and  often  keep  it  up  until  the 
next  feeding.  This  is  because  the  food  is 
insufficient,  or  at  any  rate  because  there  is 
something  wrong  with  it.  Many  a  mother 
has  mistaken  hunger  for  colic. 
LOSS  of  Older  children  also  should  be  hungry  when 
m  older  it  is  time  to  eat.  I  think,  perhaps,  I 
en'  have  more  difficulty  with  their  appetites 
than  I  do  with  the  babies',  for  we  have  to 
control  both  mother  and  child  after  infancy, 
while  the  baby  always  has  to  do  as  the  mother 
wills.  Sweets  and  eating  between  meals 
are  the  most  frequent  causes  of  lack  of  appe- 
tite in  older  children,  and  I  am  more  and 
more  firmly  convinced  that  the  minimum 
quantity  of  sweets  is  best  for  the  child. 
Children  with  very  poor  appetites  should 
be  denied  sweets  altogether,  for  a  time  at 
least.  Eating  between  meals  is  absolutely 
prohibited  with  the  exception  of  certain 
fruits.  Like  the  baby,  the  older  child  may 


APPETITE  23 

have   a  poor   appetite   because   his   diet   is 
wrong. 

A  hearty  child  has  no  right  to  be  finical 
about  his  eating.  He  should  eat  whatever 
is  put  before  him,  and  be  glad  to,  provided 
it  is  the  proper  food.  A  certain  amount  of 
firmness  on  the  part  of  the  mother  is  all  that 
is  necessary.  If  he  refuses  the  food  he  should 
eat,  let  him  go  hungry  until  the  next  meal. 
Why  should  we  neglect  to  educate  our  chil- 
dren to  eat  the  proper  food  and  teach  them 
such  accomplishments  as  German  and  music  ? 

Too  much  monotony  in  the  food  of  course  variety 
spoils  the  relish;  the  greediness  with  which  Q^ntit 
a  child  will  devour  a  different  kind  of  bread  °fFood- 
is  pathetic. 

"Can  a  child  eat  too  much  sensible  food  ?" 
is  a  question  I  sometimes  hear.  Occasionally 
I  have  seen  children  who  had  to  have  the 
amount  of  good  food  limited,  but  usually 
a  child  who  eats  too  much  in  bulk  has  some 
element  of  the  food  in  insufficient  quantity. 

Many  mothers  will  be  surprised  to  hear 
that  a  child  may  drink  too  much  milk.  If 
there  is  any  one  article  of  diet  that  is  overesti- 
mated, it  is  milk.  Most  mothers  are  imbued 


24  THE    HEALTHY   BABY 

with  the  idea  that  if  their  children  will 
Value  of  drink  milk,.they  are  well  fed.  Milk  is  a  good 
food,  but,  after  the  first  year,  must  not  be 
given  to  the  exclusion  of  other  foods.  Time 
and  time  again  I  have  children  brought  to 
me  who  do  not  eat  because  they  drink  one 
to  two  quarts  of  milk  a  day.  It  is  often 
necessary  to  take  away  the  milk  altogether, 
especially  during  the  second  year,  in  order 
to  get  the  child  hungry  enough  to  eat  other 
things. 

Diet  both  in  infants  and  children  is  a  sub- 
ject which  I  will  take  up  by  itself. 

VOMITING 

Persistent  MEDICALLY  there  is  a  distinction  between 
lilUQ{  vomiting  and  regurgitation,  but  it  is  difficult 
infants.  ^o  (.gjj  where  one  begins  and  the  other  leaves 
off.  It  is  a  fact,  however,  that  a  perfectly 
well  baby  overflows  just  after  he  has  nursed, 
and  this  is  supposed  to  be  regurgitation.  It 
is  simply  because  he  has  taken  a  little  more 
than  his  stomach  can  hold,  and  the  surplus 
comes  up.  Children  vomit  very  easily. 
This  is  a  fortunate  provision  of  nature,  be- 
cause they  have  not  the  discretion  about 


VOMITING  25 

eating  that  adults  are  supposed  to  have. 
However,  nursing  babies  should  not  vomit 
much  after  the  feeding,  and  it  is  particularly 
significant  of  ill  health  if  the  milk  makes  its 
appearance  continuously  or  just  before  an- 
other feeding  is  due.  Perhaps  baby  is  nurs- 
ing too  often  or  too  many  times  at  night,  or 
the  milk  comes  too  fast,  or  perhaps  he  is 
jostled  about  too  much  after  nursing.  When 
the  stomach  is  full,  baby  should  be  kept 
quiet,  for  if  he  is  trotted  about  or  turned  up- 
side down,  up  comes  the  food.  Tight  belly- 
bands  are  also  a  frequent  cause  of  vomiting ; 
in  fact,  any  detail  of  baby's  daily  existence 
should  be  looked  into  when  the  vomiting  is 
persistent.  These  things  are  as  true  of  the 
bottle-fed  baby  as  of  the  breast-fed.  With 
the  former,  however,  the  food  is  the  chief 
source  of  the  trouble,  when  baby  vomits 
habitually. 

Sudden  or  acute  vomiting  in  the  previously  sudden  or 
healthy  child  means  the  beginning  of  almost  vomiting 
anything.     All  acute  illnesses  of    childhood 
-  pneumonia,  scarlet  fever,  or  what  not  - 
may  begin  with  vomiting.     If  I  wanted  to 
take  a  chance,  however,  I  should  say  it  was 


26  THE    HEALTHY   BABY 

stomach  upset  —  the  child  had  overloaded 
his  stomach  or  eaten  some  bad  food,  for 
this  is  the  cause  in  the  vast  majority  of 
children  with  acute  vomiting.  It  is  usu- 
ally accompanied  by  fever,  sometimes  by 
diarrhea. 

"stomach       When   children  have   " stomach  attacks" 
decider  a^  intervals  of  a  month  or  two,  there  will  be 

Children.  foun(j  SOme  error  in  their  diet  to  account  for 
it  and  that  error  should  be  sought  and  rem- 
edied. These  attacks  should  not  be  con- 
sidered unavoidable  incidents  in  a  child's 
life.  How  often  do  I  hear  a  mother  say, 
"John  has  been  perfectly  well  all  his  life, 
but,  of  course,  he  has  one  of  his  vomiting 
spells  every  once  in  a  while." 

The  treatment  of  acute  vomiting  is  simple. 
Immediately  stop  all  food,  even  the  breast 
(and  in  older  children,  water  also),  where  it 
is  persistently  rejected.  Calomel  is  at  once 
given  in  the  method  that  I  have  described 

Treatment  under   "Diarrhea."      Castor   oil   is   not    as 

Vomiting!  g°°d  m  cases  of  vomiting  as  calomel,  because 
it  is  less  apt  to  be  retained  and  thus  its  effect 
is  spoiled.  However,  if  castor  oil  is  given 
and  retained,  it  acts  more  quickly.  If  it  is 


VOMITING  27 

vomited,  the  calomel  should  be  started  at 
once.  Citrate  of  magnesia,  as  ordinarily 
put  up  by  the  druggist,  is  sweet  and  sirupy 
and  should  not  be  used  in  these  particular 
cases.  One  level  teaspoonful  of  good  cooking 
soda  in  one  glassful  of  water,  to  be  sipped  at 
intervals,  is  helpful  in  the  vomiting  of  older 
children.  If  the  child  continues  to  vomit 
after  twelve  hours,  he  needs  the  physician's 
aid. 

Bile  in  the  vomitus  (a  watery  fluid  stained 
green  or  yellow)  always  inspires  the  mother 
with  fear.  It  simply  means  that  the  food  has 
all  been  cleared  out  of  the  stomach  and  that 
the  vomiting  has  continued  until  the  stomach 
has  become  irritable,  the  bile  flowing  back 
into  the  stomach.  Not  until  the  vomiting 
has  ceased  entirely  for  a  number  of  hours 
and  water  is  retained,  should  food  be  given. 
Bottle  babies  should  first  be  started  on  a 
very  weak  food.  Older  children  may  have 
two  or  three  tablespoonfuls  of  hot  clear 
broth,  free  of  fat,  or  bouillon,  to  begin  with. 
Later,  other  foods  are  gradually  added  to 
the  diet.  Milk  especially  should  be  avoided 
for  a  few  days. 


28  THE   HEALTHY   BABY 

THE  BOWELS 

BABY'S  bowels  have  to  be  watched  from 
the  time  he  is  a  helpless  infant  until  he  is 
old  enough  to  have  a  care  of  them  himself. 
He  must  grow  up  with  the  knowledge  that 
his  bowels  perform  one  of  the  most  important 
functions  of  the  body  and  it  is  a  part  of  his 
training  to  learn  to  take  care  of  them. 
Normal  During  the  first  three  or  four  days  the 
mental  movements  are  black  and  sticky,  two  to  four 
*  fedBBSb£  in  number.  Then,  as  the  food  begins  to  be 
taken  and  digested,  they  become  yellow  and 
more  solid  and  should  be  one  to  four  in  num- 
ber daily.  At  this  time  they  occasionally 
remain  scanty  and  even  become  green  and 
thin  for  a  week  or  so.  This  is  because  the 
milk  is  not  sufficient  to  make  good-sized 
solid  stools,  although  the  stools  may  be  fre- 
quent. Usually  the  milk  increases  by  the 
end  of  the  second  week,  so  there  is  no  occa- 
sion to  worry.  And  now  the  stools  change 
according  to  the  food  baby  is  taking.  If  he 
is  breast-fed,  they  should  become  light  yellow, 
about  the  consistency  of  mush,  and  two  to 
four  a  day.  A  few  weeks  later  one  a  day  will 


THE   BOWELS  29 

answer.  I  would  caution  mothers  not  to 
be  too  much  worried  about  the  number  of 
the  breast-fed  baby's  stools  when  he  is  sleep- 
ing well  and  everything  else  seems  right,  es- 
pecially if  he  gains  in  weight. 

The  bottle-fed  baby  should  be  under  the  The 
care  of  the  physician  during  the  first  weeks,  «BabVs  e° 
as  the  great  majority  of  sick  babies  owe  their  Stools- 
ill  health  to  the  poor  start  they  get  in  the 
early  weeks.  However,  if  properly  fed,  the 
bowels  of  the  bottle-fed  baby  are  not  apt  to 
move  as  often  as  those  of  the  breast-fed  child. 
One  stool  a  day  is  sufficient,  and  even  if  there 
is  only  one  stool  in  forty-eight  hours,  it  is 
better  to  let  them  go  that  length  of  time 
rather  than  to  irritate  the  bowels  daily  with 
cathartics  and  enemas  and  suppositories. 
The  food  can  be  changed  gradually  so  that 
the  bowels  will  move  of  their  own  accord 
every  day. .  The  bottle-fed  baby  also  has  a 
larger  and  more  bulky  stool,  lighter  in  color, 
and  about  the  consistency  of  a  firm  ointment 
or  cold  cream,  so  that  it  holds  its  shape  in  the 
diaper.  It  should  be  smooth  and  uniform. 
Any  curds  (white  lumps  like  cheese)  or  mucus 
(glistening,  slimy,  like  phlegm)  show  that 


30  THE    HEALTHY   BABY 

the  food  is  not  being  well  digested  in  the 
bowels,  where  most  of  the  infant's  digestion 
takes  place.  Usually  this  is  a  sign  of  diarrhea. 
Training  When  baby  reaches  the  age  of  four  months, 
Regu°  ^  ne  is  strong  and  well,  we  begin  to  train  him 
Habits.  ^.Q  nave  stools  at  regular  intervals.  It  is 
•  surprising  how  soon  the  little  things  learn  to 
use  the  vessel.  At  stated  times  each  day 
(once  or  twice,  according  to  his  previous 
habits)  he  is  placed  upon  a  small  infant's 
chamber,  which  is  comfortable  if  it  exactly 
fits  the  buttocks.  This  may  be  held  in  the 
lap  in  order  to  support  his  back.  He  soon 
learns  to  grunt  and  strain  whenever  he  is 
placed  upon  it,  and  the  habit  is  quickly  es- 
tablished. When  he  gets  strong  enough  to 
sit  up  by  himself,  he  must  have  a  low  com- 
fortable chair  which  allows  the  feet  to  rest 
upon  the  floor.  The  chair  should  have  a 
rubber  ring  which  can  be  taken  off  and 
cleaned.  This  may  be  bought  at  any  chil- 
dren's store.  It  is  a  most  pernicious  habit  to 
allow  the  adult  chamber  to  be  used,  because 
its  large  size  tends  to  let  the  organs  become 
displaced. 

And  finally,  as  he  grows  still  older  and  has 


THE   BOWELS  31 

three  meals  a  day,  he  must  learn  that  he 
must  go  to  stool  at  the  same  time  each  day 
(preferably  right  after  breakfast)  and  stay 
there  until  his  bowels  have  moved.  In  this 
way  a  habit  is  established  which  is  carried 
through  life. 

Constipation  has  many  causes.     In  breast-  Constipa- 
fed  children  it  is  usually  due  to  constipation  Breast-fed 
of  the  mother  or  to  the  mother's  diet  or  to  Infants- 
irregular  nursing.     These  things  we  will  con- 
sider under  " Breast  Feeding."     If  the  con- 
stipation   continues    after   mother's    diet   is 
corrected  and  her  bowels  regulated,  it  is  far 
wiser  to  consult  a  physician  than  to  try  sweet 
oil  and  cream  and  various  other  expedients 
which  require  skilled  supervision.     It  often 
happens,  if  oil  is  used,  that  it  is  just  the  wrong 
thing  if  the  fault  lies  in  a  milk  already  too 
rich  in  fat. 

The  bottle-fed  baby  is  constipated  also  Constipa- 
because  of  his  food.  The  most  usual  errors  Bottle-fed 
of  diet  are  :  -  Infants- 

1.  Too  high  a  fat  (when  top  milk  or  cream 
is  used). 

2.  Food  of  insufficient  quantity  or  strength 
(scanty  stools). 


32  THE    HEALTHY   BABY 

3.  Not  enough  sugar. 

4.  Boiling  the  milk. 

5.  Weak,   sickly   babies  are  often  consti- 
pated because  they  have  not  enough  strength 
and  muscular  tone  to  have  an  evacuation. 

One  can  readily  see  how  wrong  it  is  to 
give  cathartics  every  day  without  remedying 
the  cause,  when  the  child's  nutrition  and 
growth  may  suffer  from  the  error  in  diet 
which  has  caused  the  constipation.  Hav- 
ing decided  which  of  the  above  five  causes 
gives  rise  to  the  constipation,  changes  in  the 
food  should  be  made  accordingly.  Tem- 
porarily, however,  milk  of  magnesia  may 
be  used  until  the  food  is  properly  regulated, 
one  teaspoonful  one  to  six  times  a  day  in  the 
bottle  or  just  before  the  breast  feeding. 
After  six  months  of  age,  the  fruit  juices  and 
raw  scraped  apple,  such  as  I  describe  in  the 
diet  list,  are  useful. 

Causes  of       Older  children  are  constipated  because  :  — 
^'tfonfa       1-   They  have  not  been  taught  to  go  regu- 
ChiidreiT  larly  *°  stool,  and  they  are  too  busy  at  play 
when  they  have  the  inclination  to  go. 

2.  The  toilet  arrangements  are  not  com- 
fortable. Often  the  feet  hang  dangling  while 


THE   BOWELS  33 

they  sit  upon  the  adult  water-closet,  or  the 
seat  is  too  large. 

3.  During    the    second    and    third    years 
particularly,  too  much  milk  is  often  given. 
It  is  sometimes  necessary  to  take  milk  out 
of  the  diet  entirely  if  the  constipation  stub- 
bornly resists  dietetic  treatment. 

4.  The   food   may   be   too   concentrated. 
The  child  has  not  learned  to  like  vegetables 
or   the   coarser   breads   and    cereals,    which 
should  be  given  in  large  quantities  to  con- 
stipated   children.     A    diet    list   for   consti- 
pated children  will  be  given  later. 

5.  Fruits  are  not  given  in  sufficient  quan- 
tities, for  they  are  especially  valuable  addi- 
tions to  the  diet.     By  this  I  do  not  mean  a 
little   orange  juice  at   breakfast.     Give  the 
child  all  the  fruit  he  will  eat  three  times  a 
day,  preferably  between  meals,  until  the  con- 
stipation is  overcome. 

6.  There  may  rarely  be  some  abnormal 
condition  about  the  rectum,  such  as  a  fissure, 
hemorrhoids,    polypus,   or    prolapse,    which 
needs  medical  attention. 

Massage  of  the  abdomen  is  a  very  valuable  Massage 
adjunct   in   the   treatment   of   constipation ; 


34  THE   HEALTHY   BABY 

it  consists  in  very  gently  stroking  the  abdo- 
men with  the  tips  of  the  fingers,  first  upward 
on  the  right  side,  then  across  from  right  to 
left  in  the  upper  part  of  the  abdomen,  then 
downward  on  the  left  side.  This  is  followed 
by  a  general  light  and  careful  kneading  of 
the  whole  abdomen.  Do  not  use  too  much 
strength.  Never  massage  the  abdomen  im- 
mediately after  feeding. 

Principal  Diarrhea  is  more  to  be  dreaded  in  in- 
Dferrhea.  fancy  than  almost  any  other  illness.  In  the 
large  cities,  during  the  summer  months, 
more  babies  die  of  diarrhea  than  of  scarlet 
fever,  diphtheria,  typhoid  fever,  measles, 
and  whooping  cough  combined.  Diarrhea, 
therefore,  should  be  treated  in  the  beginning. 
In  infancy  there  are  but  two  principal  causes 
of  diarrhea  —  unclean  milk  and  the  wrong 
food. 

Diarrhea       Unclean  milk  may  come  from  improperly 

Unclean  managed  dairies  or  from  contamination  in 

MQk-  the  home  between  the  time  it  is  delivered 

and  the  time  it  is  consumed  by  the  baby. 

Fortunately  the  best  milk  in  the  world  may 

be  had  in  New  York  City  and  in  all  of  the 

large   American   cities  where   certified   milk 


THE   BOWELS  35 

is  available.  It  is  delivered  in  a  clean  bottle 
packed  in  ice,  and  if  kept  cold  and  clean  un- 
til the  baby  gets  it,  he  will  not  be  poisoned 
by  it.  Cleanliness,  rapid  cooling,  and  keeping 
it  cool  is  the  whole  secret  of  good  milk.  This 
can  be  accomplished  on  the  farm  when  certi- 
fied milk  is  not  within  our  reach.  Babies' 
bottles  and  nipples  and  everything  the  milk 
comes  in  contact  with  should  be  kept  scru- 
pulously clean. 

Improper  feeding  even  of  clean  milk  often  Diarrhea 
results  in  diarrhea.  Diarrhea  and  vomit-  prr°oper 
ing  are  conservative  processes  of  nature  which  Feedmg- 
the  baby  automatically  performs,  to  get  rid 
of  that  which  our  minds  have  been  deficient 
in  rejecting.  Overfeeding  is  perhaps  the  most 
frequent  kind  of  improper  feeding.  It  is  as 
fascinating  as  a  game  to  watch  the  weight  of 
a  baby  go  up  each  week.  Therefore  we  must 
have  a  care  not  to  increase  the  strength  of 
the  food  too  fast  in  our  anxiety  to  increase  the 
weight.  Too  frequent  feedings  also  cause 
diarrhea.  During  the  hot  weather  a  baby 
will  not  digest  as  much  food  as  he  will  in  the 
winter  months.  He  should  be  kept  hungry 
and  perhaps  it  will  be  necessary  to  cut  down 


36  THE   HEALTHY   BABY 

the  strength  of  the  food  while  the  weather 
is  very  hot.  The  baby  will  also  be  less  in- 
clined to  have  diarrhea  if  he  is  not  too 
warmly  clothed  and  if  he  has  plenty  of  fresh 
air. 

The       The  "second  summer"  is  a  most  dreaded 
"Second  period  in  the  minds  of  most  mothers  —  and 

Summer."  wny  ?  j^  js  because  baby  has  reached  the 
age  when  he  wants  to  eat  everything  he  sees, 
and  mother  allows  him  to  do  so  or  doesn't 
take  pains  to  prevent  him,  that  he  gets  up  a 
diarrhea.  The  second  summer  should  be, 
however,  and  is  the  healthiest  part  of  the 
child's  life,  provided  his  diet  is  right.  To  be 
sure  he  may  be  cutting  some  teeth  at  this 
time,  but  if  he  is  kept  cool  and  comfortable 
and  is  properly  fed,  he  is  not  very  liable  to  a 
diarrhea  from  teething.  I  must  admit  that 
he  requires  more  care  when  he  is  cutting  his 
teeth  in  the  summer,  and  that  there  are 
children  who  have  a  tendency  toward  loose 
bowels  when  the  teeth  are  coming  through, 
but  careful  supervision  will  tend  to  avoid 
much  difficulty. 
Treatment  All  I  have  said  has  been  in  the  way  of  pre- 

Dian-hea.  vention  of  diarrhea  which  is  by  far  the  most 


THE   BOWELS  37 

important  side  of  the  subject.  What  about 
the  child  who  has  actually  started  with  diar- 
rhea? The  moment  the  disorder  begins  is 
the  time  to  start  treatment.  Stop  all  milk 
or  food  of  any  kind  at  once.  Even  the  breast 
should  be  discontinued  for  at  least  twelve 
hours  in  nursing  babies.  Give  a  cathartic, 
either  castor  oil  o*  calomel  —  -^Q  to  I  grain 
every  half  hour  until  one  to  two  grains 
is  given,  according  to  the  age.  Calomel 
is  better  when  there  is  vomiting,  and  a 
large  dose  of  castor  oil  is  better  than  a  small 
one.  During  the  first  few  months  a  tea- 
spoonful  will  be  sufficient,  but  after  that 
a  tablespoonful  is  required  to  do  the  work 
well.  If  the  castor  oil  is  vomited,  start  the 
calomel. 

Do  not  give  anything  else  by  mouth  but 
water,  and  water  should  be  limited  or  denied 
if  there  is  much  vomiting;  otherwise,  it  should 
be  given  plentifully.  If  the  child  has  much 
fever  or  if  the  diarrhea  has  not  stopped  in 
twelve  to  twenty-four  hours,  a  physician's 
services  will  be  required.  Many  a  long  ill- 
ness has  been  prevented  by  this  energetic 
treatment  in  the  beginning. 


PART   II 
HYGIENE  AND  TRAINING 


CLOTHING 

THERE  is  one  invariable  rule  in  dressing  TheSen- 
a    baby  —  always    make    him    comfortable.  SSsed 
There  is  no  more  necessity  of  wrapping  him  Baby- 
round  and  round  with  pinning  blankets  than 
there  is  of  binding  his  feet  as  the  Japanese 
do'    We  have  been  hampered  long  enough 
in  our  dress  by  custom  and  tradition,  but 
fortunately  we  are  now  dressing  our  babies 
in  a  sensible  manner.     When  the  baby  is 
entirely  dressed,  he  has  on  a  belly-band,  a 
shirt,  a  flannel  skirt,  a  soft  sheer  underskirt, 
a  simple  dress  or  slip,  socks,. and  diapers. 

The  belly-band  serves  'Wo  purposes  -  -  The  Beiiy- 
it  supports  the  abdomen  in  the  very  young  band- 
infant  and  it  protects  the  bowels  from  changes 
in  temperature.  Improperly  used,  it  is  a 
source  of  discomfort  and  even  positive  harm. 
As  soon  as  the  babe  becomes  very  active, 
the  pinned  belly-band  works  up  under  the 
arms  where  it  restricts 'the  breathing  rather 
than  protects  the  abdomen.  The  belly- 
band  should  be  made  of  an  unhemmed  strip 
of  soft  white  flannel,  eight  inches  wide  and 
eighteen  inches  long,  so  that  it  goes  around 
41 


42  THE    HEALTHY   BABY 

the  abdomen  once.  It  may  be  pinned  firmly, 
but  not  too  tightly,  with  five  small  safety 
pins.  It  is  not  necessary  to  sew  it  on  the 
child  as  is  the  fad  at  the  present  time.  It 
should  be  discarded  at  eight  weeks  of  age 
(if  the  child  is  strong  and  well)  and  a  loose 
knitted  band  with  shoulder  straps  substituted 
for  it.  The  knitted  band  should  be  pinned  ^o 
the  diapers  at  the  bottom.  Three  thicknesses 
are  commonly  sold,  the  medium  silk  and  wool 
being  the  best.  It  should  be  worn  throughout 
tjie  first  year. 

The  shirt,  coming  next  to  the  baby's  deli- 
cate skin,  should  be  of  soft  texture.  The 
medium  grade  of  silk  and  wool  is  preferable, 
or  a  cotton  shirt  may  be  used.  It  should  fit 
the  body  closely  enough  to  eliminate  wrinkles, 
which  are  a  source  of  discomfort  in  any  article 
of  baby's  clothing.  Heavy  rough  woolen 
underclothes  are  unnecessary  and  positively 
harmful  at  any  age. 

The       The  flannel  skirt,  which  nowadays  takes 
kirt.  the  place  of  the  uncomfortable  pinning  blan- 
ket, is  made  with  straps  which  pin  over  the 
shoulders  (one  back  and  front  for  each  shoul- 
der).    It  should  be  made  of  soft  white  flannel 


CLOTHING  43 

and  be  twenty-six  inches  long.  The  white 
skirt  which  goes  over  this  is  not  a  necessity, 
but  a  luxury  for  dressy  occasions.  It  should, 
of  course,  hang  from  the  shoulders. 

The  dress,  or  slip,  twenty-seven  inches  in  The  Dress, 
length,.,should  be  simple,  but  no  matter  how 
elaborate  it  is,  it  should  have  no  lace  about 
the  neck  to  cause  irritation  of  the  skin.  I 
have  seen  bad  cases  of  eczema  started  in  this 
way.  The  neck  should  not  be  tight  and  it  is 
best  tied  with  a  tape  in  the  back,  rather  than 
fastened  with  pins  or  buttons  for  the  baby  to 
lie  upon.  Sheer  batiste  or  nainsook  is  the 
best  material  both  for  the  underskirt  and 
for  the  outer  slip.  The  stockinette  night- 
gowns are  very  nice  and  may  be  worn  night 
and  day  in  the  early  months,  if  we  do  not 
care  to  be  dressy. 

A  jacket,   as   mentioned   below,   may  be 
worn  on  cool  days  after  the  child  is  old  enough 
to  sit  up.     Socks  are  worn  in  winter,  but    /- 
never  heavy  woolen  ones.     They  should  be 
pinned  to  the  diapers  and  not  tied  on. 

The  diaper  problem  is  an  important  one,  The 
especially  in  the  city  apartment  where  baby's  Probfem. 
laundry  has  to  be  done  up  every  day  in  a 


44  THE    HEALTHY   BABY 

small  space.  Cheesecloth  diapers  are  the 
nicest  for  the  little  baby.  They  are  soft  and 
easily  dried.  They  are  cut  a  yard  square 
and  hemmed.  When  folded  cornerwise  three 
times,  making  eight  thicknesses,  they  are 
about  the  right  size.  The  stork  diaper  may 
be  used  in  addition  to  these  where  two  diapers 
are  necessary.  These  stork  diapers  are  made 
of  material  which  is  like  thick  Turkish  towel- 
ing, and  they  come  in  different-sizes  which  are 
Rubber  three-cornered  in  shape.  They  should  not  be 
confused  with  the  diapers  made  of  a  rubber 
sheeting  which  bears  the  same  name.  The 
latter  should  never  be  worn,  since  they  cause 
irritation  about  the  buttocks,  as  well  as  being 
a  source  of  great  discomfort.  As  the  child 
gets  older,  the  cotton  bird's-eye  diaper  may 
be  used  together  with  the  larger  sized  stork. 
The  diapers  should  be  changed  as  soon  as 
the  baby  has  wet  them,  always  before  a  nurs- 
ing, although  it  is  not  advisable  to  waken 
him  just  to  change  them.  Soiled  or  wet 
diapers  should  be  put  immediately  into  a 
covered  enamel  pail,  kept  exclusively  for 
that  purpose,  and  washed  out  each  morning. 
Under  no  circumstances  should  a  diaper  be 


CLOTHING  45 

used  twice  without  washing.  After  the  first 
year,  diapers  should  be  discarded  for  drawers 
and  waists.  Rompers  should  not  be  worn 
until  baby  has  learned  to  keep  himself  dry 
in  the  daytime. 

Blankets  seem  almost  a  part  of  the  baby,  Biankete. 
they  are  so  numerous  where  he  abides. 
While  sleeping,  the  number  of  blankets 
necessary  should  be  judged  by  the  tempera- 
ture of  the  room.  When  we  have  baby  in 
our  arms,  one  blanket  is  well  in  winter,  but 
after  he  is  old  enough  to  sit  up,  the  jacket 
should  be  substituted  for  it.  Winding  the 
blanKet  around  him  is  unnecessary  and  un- 
comfortable even  when  he  is  out  in  his  car- 
riage. In  fact  I  have  seen  temporary  par- 
alysis of  the  arm  from  pressure  of  the  tightly 
wound  blanket. 

In  putting  on  baby's  clothes  he  should  lie  Changing 
flat  upon  the  nurse's  lap,  and  the  clothes  ciothes.y' 
should  be  drawn  over  the  feet  and  not  over  the 
head.     Baby's  clothes  should,  of  course,  be 
changed  throughout  once  each  day  at  the 
time    of   his    bath.     During    the    first    four 
months  it  is  not  necessary  to  change  to  night 
clothes  at  night,   except  for  dressy  babies 


46  THE    HEALTHY   BABY 

who  wear  fancy  gowns  in  the  daytime. 
Night  and  day  are  very  much  alike  to  him. 
At  four  months  short  clothes  may  be  worn. 
The  one  thing  above  all  others  that  I  have 
to  talk  to  my  patients  the  most  about  is 
overdressing.  Not  only  are  mothers  apt  to 
bundle  up  their  babies  too  much,  but  their 
older  children,  as  well.  During  the  hot 
weather  baby  should  be  kept  cool.  On  hot 
The  days  the  flannel  skirt  and  socks  and  even  the 
Dressing  shirt  should  come  off,  provided  the  baby  is 
strong  and  doing  well.  Any  baby  who  per- 
spires is  dressed  too  warmly.  This  is  the 
thing  that  governs  me  in  dressing  my  baoies. 
It  is  perfectly  easy  to  slip  on  a  flannel  skirt 
when  a  cool  day  comes,  for  it  does  no  harm 
to  change  the  thickness  of  the  clothing  from 
day  to  day  as  the  weather  changes.  Babies 
who  are  too  warmly  dressed  do  not  digest 
their  food  as  well  and  are  apt  to  vomit  or 
have  loose  bowels  when  the  hot  days  come. 
Nor  is  it  advisable  to  have  too  warm  cloth- 
ing in  the  house  in  the  winter.  Remember 
that  the  average  house  or  steam-heated  apart- 
ment is  70°  or  even  80°  in  temperature,  which 
would  be  considered  a  warm  day  in  summer. 


CLOTHING  47 

In  older  children  especially  is  this  error  apt  How  to 
to  occur.  The  average  mother  has  such  a  order 
fear  of  her  child's  catching  cold  that  she  gets  ?hco[jn 
the  warmest,  thickest  underclothes  she  can  Weather, 
buy.  The  child  is  overheated  in  the  house 
and  then  goes  out  with  a  skin  which  is  moist 
and  "coddled,"  so  that  it  does  not  react  to 
different  temperatures,  as  it  should  and  which 
is  one  of  its  chief  functions.  Probably  more 
colds  are  acquired  in  this  way  than  in  any 
other,  all  through  the  mother's  anxiety  to 
prevent  them.  I  never  allow  any  thick 
woolen  underclothes  at  all,  winter  or  summer 
in  this  climate.  "The  girl  has  her  flannel 
skirt,  cotton  underdrawers,  waist,  shirt,  and 
stockings,  and  after  she  is  too  old  to  wear 
leggings  out  of  doors,  she  may  have  light- 
weight underflannels  coming  to  the  ankles. 
The  boy,  after  he  has  come  to  trousers,  may 
wear  balbriggan  underdrawers  and  shirt,  and 
knitted  waists  or  suspenders  to  support  the 
trousers.  When  they  go  out  doors  in  cold 
weather,  children  should  wear  leggings  and 
a  warm  coat.  In  fact  they  are  far  less  apt 
to  catch  cold  if  we  save  the  warm  woolen 
things  for  out  doors  and  dress  them  com- 


48  THE    HEALTHY   BABY 

fortably  in  the  house.  Fur  earlaps  are  per- 
nicious things.  They  are  worn  on  cold  days 
and  when  taken  off  occasionally  on  a  warm 
day,  the  ear,  being  unaccustomed  to  the 
change,  is  apt  to  suffer.  I  have  repeatedly 
seen  abscesses  of  the  ear  which  I  believe  to 
have  been  contracted  in. this  way.  In  win- 
ter it  is  well  to  have  a  bonnet  or  some  pro- 
tector for  the  ears  for  children  under  two 
years,  but  after  that,  a  veil  tied  over  the  hat 
on  cold  days  is  sufficient.  Even  the  thick- 
ness of  the  bonnet  should  not  be  changed 
from  day  to  day. 

Socks.  Socks  for  older  children  are  well  enough 
in  summer,  but  absolutely  tabooed  in  winter. 
Some  mothers  have  the  idea  that  it  "har- 
dens" their  children  to  let  them  go  about  in 
winter  with  no  covering  for  the  legs.  It  is 
not  only  a  foolish  idea,  but  a  harmful  one. 
Full-length  stockings  should,  therefore,  be 
worn  except  in  the  summer  months. 

Shoes.  The  shoes  should  be  broad  in  the  toe  and 
always  plenty  long  enough.  Children's  feet 
grow  so  fast  that  it  is  often  a  temptation  to 
allow  them  to  wear  a  perfectly  good  shoe  even 
though  it  is  a  trifle  short.  Let  us  hope  that 


THE   BATH  49 

there  is  another  baby  in  the  family  who  will 
come  along  soon  to  save  them  if  one  is  eco- 
nomically inclined.  Soft,  thin  shoes  are  best 
for  the  feet  in  the  second  year  when  baby  is 
learning  to  walk.  The  present  style  of  thick, 
hardy  looking  shoes  should  be  reserved  for 
the  older  child.  Rubbers  or  overshoes  should 
always  be  worn  on  damp  or  cold  days,  as 
the  thin  shoes  are  so  easily  penetrated  by 
the  cold  or  moisture.  Wet  feet  may  not  do 
any  harm,  but  they  never  do  any  good. 

At  night,  since  the  nursery  windows  are  Night 
to  be  wide  open  in  the  winter,  the  clothing  i 
should  be  warm.  The  infant  has  more 
blankets,  and  the  older  child  an  undershirt 
and  outing  flannel  or  woolen  "Johnnie  Bears  " 
-  one-piece  suits  with  feet  in  them,  the  num- 
ber of  blankets  varying  with  the  temperature. 

THE  BATH 

BABY'S  first  full  tub  bath  comes  when  he  The  Bath- 
is  about  a  week  old  (when  the  cord  has  come  * 
off)  and  from  that  time  on  he  should  have  one 
bath  daily  throughout  childhood.     The  room 
should    be     warm,     but     not     overheated, 
75°    to    80°  F.,  and   there    should    be    no 


50  THE    HEALTHY   BABY 

draughts  about.  A  metal  or  enameled  bath- 
tub is  a  necessity  and  it  should  be  kept  scru- 
pulously clean.  The  folding  rubber  bath- 
tubs are  very  hard  to  keep  clean  and  I  do 
not  approve  of  them  entirely.  If  one  is  used, 
it  should  be  thoroughly  cleaned,  dried,  and 
aired  each  day.  I  have  seen  a  nurse  put 
soiled  diapers  into  the  bathtub  to  soak,  with 
the  result  that  might  be  expected  —  infec- 
tion of  the  baby's  skin  and  a  good  crop  of 
boils. 

HOW  to  The  baby's  head  and  face  must  first  be 
^aby!  washed  and  dried.  The  eyes,  nose,  ears,  and 
genitals  are  then  cleaned  with  a  fresh  piece 
of  absorbent  cotton  dipped  in  a  bowl  of 
boracic  acid  and  water,  a  teaspoonful  to  the 
pint.  The  mouth  should  be  left  alone,  not 
only  at  the  time  of  the  bath,  but  at  all  times. 
One  of  the  most  pernicious  practices  of  the 
present  time  is  the  constant  scrubbing  of 
the  inside  of  the  mouth.  The  mucous  mem- 
brane or  lining  of  the  mouth  is  often  injured 
in  this  way,  and  makes  it  far  more  liable  to 
thrush  and  other  infections  instead  of  prevent- 
ing them.  The  baby's  mouth  will  take  care 
of  itself  and  be  far  better  cleansed  by  its 


THE    BATH  51 

own  saliva.  The  baby  should  be  thoroughly 
soaped  in  the  lap  and  then  laid  in  the  bath- 
tub to  wash  the  soap  off,  with  the  head 
supported.  Under  no  circumstances  is  the 
sponge  or  washcloth  to  be  used  for  little 
babies.  A  fresh  clean  piece  of  absorbent 
cotton  is  much  better.  Every  baby  should 
love  the  bath ;  if  there  is  any  crying,  it  should 
be  only  when  he  comes  out  of  it.  After  the 
bath,  the  baby  is  quickly  dried  with  a  clean, 
soft  (possibly  old)  towel,  but  with  very  little 
rubbing,  and  the  folds  of  the  skin  powdered. 

The  temperature  of  the  bath  is  as  follows :  The  Tem- 
The  first  eight  weeks,  100°  F. ;  until  six  t^Batfi0 
months,  98°  F. ;  after  six  months,  95°  F.  ; 
during  the  second  year,  85°  to  80°  F.  After 
the  second  year,  at  the  end  of  the  bath,  a  cold 
douche  poured  over  the  child  at  the  tempera- 
ture of  the  cold  water  faucet  is  stimulating, 
and  keeps  him  from  catching  cold.  A  bath 
thermometer  is  a  necessity.  It  should  not 
be  discarded  after  the  first  few  months,  as  is 
the  custom  in  most  of  the  families  with  whom 
I  come  in  contact.  Any  child  who  has  been 
accustomed  to  warm  or  hot  baths  should  have 
the  temperature  lowered  a  little  each  day 


52  THE   HEALTHY   BABY 

until  the  proper  temperature  for  his  age  is 
reached. 

The  Time  The  time  of  the  bath  is  not  of  vast  impor- 
tance. It  should,  however,  come  before  eat- 
ing. The  infant  is  more  apt  to  need  it  in 
the  morning,  and  it  is  my  custom  to  give  a 
morning  bath  throughout  the  first  year,  and 
an  evening  bath  after  that  time. 

In  all  of  these  talks,  I  have  in  mind  the  well 

baby,  but  perhaps  it  would  be  best  to  say  a 

word  about  the  sickly  baby's  bath.     Small, 

thin,  emaciated  babies   often   do  not  stand 

Certain  the  bath  well.     They,  of  course,  are  under 

Cases  when     ,,  -  ,         .    .  j    i  -n 

the  Bath  the  care  of  a  physician,  and  he  will  rec- 
ommend  a  sweet  oil  rub,  or  whatever  is 
necessary  to  take  the  place  of  the  bath. 
Children  with  eczema  or  other  skin  affections 
are  often  benefited  by  omitting  the  bath. 
However,  I  do  not  believe  the  bath  should 
be  omitted  because  the  child  has  a  cold  or  a 
little  fever  or  any  other  illness  too  slight  to 
require  a  physician's  attendance.  At  such 
times  a  bath  is  often  restful  and  quieting, 
and  the  child  goes  off  to  sleep  for  the  night 
when  he  would  otherwise  have  been  fretful 
and  restless. 


FRESH   AIR  53 

FRESH  AIR 

THE  last  generation  feared  fresh  cold  air  Draughts 
and  a  draught  as  the  present  generation  fears  ventiia- 
bacteria  and  the  germs  of  disease.  In  both  tion- 
generations  we  have  gone  too  far,  and  as 
usual  the  pendulum  has  swung  way  beyond 
its  intended  turning  point.  Plenty  of  fresh 
air  tends  to  get  us  into  such  good  condition 
that  we  may  resist  or  throw  off  colds  and 
other  illnesses  caused  by  germs ;  at  the  same 
time  overexposure  and  draughts  I  am  sure 
will  sometimes  cause  them.  Some  of  our 
leading  authorities  still  claim  that  draughts 
are  not  harmful,  but  I  believe  that  when  we 
are  in  the  house,  it  is  best  to  avoid  them,  pro- 
vided it  is  possible  to  get  a  good  supply  of 
fresh  air  coming  into  the  room  all  the  time. 
If  I  had  to  choose  between  bad  air  and 
draughts,  I  would  take  the  latter,  but  I  do 
not  think  the  choice  is  often  necessary.  In 
the  summer  a  cool  breeze  does  not  seem  to 
cause  colds.  One  hour  of  bad  air  will  do 
more  harm  than  good  air  for  the  other  twenty- 
three  will  undo ;  therefore,  keep  the  room 
well  ventilated  every  moment  of  the  day. 


54  THE    HEALTHY  BABY 

HOW  to  It  seems  to  me  that  it  takes  a  great  deal 
e  °f  thought  to  ventilate  the  individual  house 
House.  or  apartment  properly.  If  the  rooms  are 
large  and  open  into  each  other,  one  or  two 
windows  in  the  proper  place  will  furnish  fresh 
air  for  the  whole  house.  If  we  are  dealing 
with  a  small  apartment,  we  must  select  one 
room  where  the  windows  may  be  opened  top 
and  bottom  and  from  which  the  fresh  air 
may  circulate  without  causing  too  much 
of  a  breeze,  or  draught.  It  is  a  well-known 
fact  that  open  fireplaces  are  wonderfully 
good  ventilators,  but  they  are  now  considered 
a  luxury,  I  am  sorry  to  say.  At  any  cost, 
keep  the  air  good  night  and  day. 
Proper  The  temperature  of  living  rooms  should 
ISTreTf  be  65°  to  70°  F.  A  thermometer  should 
theRooms8  nanS  m  the  rooms  that  are  most  frequented 
by  the  children,  and  should  be  placed  at  the 
height  of  their  heads.  Overheating  is  the 
commonest  error  in  the  city.  In  the  country 
perhaps  the  most  usual  mistake  is  draughty 
rooms,  floors,  and  cold  halls.  On  the  other 
hand  air-tight  rooms  in  which  the  same  air  is 
breathed  over  and  over  again  without  once 
changing  is  a  common  occurrence. 


FRESH    AIR  55 

The  sleeping  room  should  have  one  or  more  VentUa- 
windows  wide  open  top  and  bottom  through-  tlwTsieep- 
out  the  year.  The  bed  should  be  as  far  away  ingRoom- 
from  the  windows  as  possible  and  in  a  corner 
out  of  the  direct  draught.  If  this  is  not  pos- 
sible, a  blanket  may  be  pinned  around  the 
crib,  so  that  the  winter  winds  will  not  blow 
directly  upon  the  baby.  It  is  sometimes  hard 
to  convince  the  mother  that  her  child  should 
sleep  in  an  unheated  room,  but  when  she  has 
once  accustomed  the  baby  to  it,  she  soon  sees 
what  a  beneficial  effect  it  has  upon  him.  He 
sleeps  more  quietly,  learns  to  keep  under  the 
bed  clothing,  and  does  not  catch  cold  nearly 
as  easily.  The  room  being  cold,  the  night 
clothing  should  be  warm,  varying  with  the 
temperature  (see  " Clothing").  This  does 
not,  of  course,  apply  to  weak,  sickly  infants 
nor  to  those  under  six  weeks  of  age.  Of 
course  in  very  cold  climates  the  temperature 
of  the  sleeping  room  should  be  kept  well  above 
the  freezing  point. 

It  is  my  observation  that  city  children  get  Outdoor 
more  fresh  air  than  country  children  during 
the  first  and  second  years.     As  is  proper,  the 
carefully  brought  up  city  child  gets  his  airing 


56  THE    HEALTHY   BABY 

at  a  stated  time  each  morning  and  each  after- 
noon. It  is  his  routine  that  saves  him,  while 
the  country  child  is  not  allowed  to  be  out 
when  the  snow  is  deep  or  the  weather  in- 
clement, and  often  is  taken  out  only  when 
convenient.  Babies,  beginning  at  six  weeks, 
should  be  taken  out  for  their  airing  once  a 
day,  and  later  two  times.  In  mild  weather  or 
in  warm  climates  they  may  be  taken  out  at  the 
9  age  of  two  weeks,  but  usually  not  earlier  than 

this.     In  winter  the  best   time  is  when  the 
sun  is  high ;  in   summer,   when   it  is  cool- 
est.    The  length  of  time  for  the  airing  de- 
pends upon  the  age  of  the  child  and  the 
time  that  can  be  devoted  to  it  by  the  mother 
or  nurse.     At  six  weeks,  an  hour  a  day  is 
sufficient ;   at  six  months  three  or  four  hours 
is  a  necessity  :  after  that  the  more  the  better. 
The  only  contra-indications  to  going  out 
are  —  extremely  cold  weather  (below  zero), 
rain  or  snow,  and  possibly  sharp  winds,  un- 
less a  sheltered  spot  can  be  found.     When 
what  to  do  this  outdoor  airing  is  absolutely  impossible, 
w™atherhis  *ne  baby  should  be  dressed  for  the  street  and 
inclement.  pu^  jn  ^he  carriage  close  by  the  widely  open 
windows  and  in  the  sun.     The  sun  should 


FRESH    AIR  57 

not  be  allowed  to  shine  directly  into  the  un- 
protected eyes,  whether  in  or  out  of  doors. 
In  the  city  it  is  as  necessary  to  have  a  car- 
riage for  the  baby  as  it  is  to  have  a  bed. 
Rainy  days  are  hard  on  any  child,  but  the 
older  one  is  sure  to  miss  his  outing.  Put  on 
his  hat  and  cloak  and  open  all  the  windows 
in  the  nursery,  and  see  how  much  pleasure 
it  gives  him,  as  well  as  rosy  cheeks. 

The  delicate  child  often  requires  fresh  air  The 
even  more  than  the  well  child.  The  appetite  child*  * 
is  improved  and  the  strength  increased  by 
good  pure  air.  Sleep  also  is  often  induced  by 
the  airing.  Many  a  sick  child  who  will  not 
sleep  well  in  the  house  immediately  sinks  into 
a  restful  slumber  as  soon  as  he  is  put  out  in 
his  carriage.  Of  course,  there  is  no  objection 
to  sleeping  out  of  doors  in  sickness  or  in 
health,  provided  the  baby  is  properly  dressed 
for  it.  Occasionally  the  mother  of  a  sickly 
child  will  tell  me  that  she  cannot  take  the 
little  one  outdoors  at  all,  because  every  time 
she  does  so  he  catches  cold.  That  is  the  very 
reason  he  is  sickly,  and  unless  he  is  taken  out 
every  day  and  accustomed  to  the  fresh  air 
treatment  he  will  always  remain  delicate. 

I 


58  THE    HEALTHY   BABY 

He  should,  therefore,  be  taken  out  in  spite  oi 
his  catching  cold  unless  he  has  a  fever. 
School-  School  children  should  have  especial  care 
paid  to  their  supply  of  fresh  air.  It  is  al- 
ways possible  for  the  energetic  parent  to 
impress  upon  the  proper  authorities  the  bene- 
ficial effects  of  fresh  air  in  the  school.  The 
modern  public  school  buildings  have  splen- 
did systems  of  ventilation,  but  private  schools 
are  often  in  dwelling  houses  that  were  not 
meant  to  hold  many  people,  so  the  air  supply 
must  be  carefully  regulated  by  means  of  the 
proper  window  ventilators.  School  children 
should  have  their  share  of  outdoor  life,  too, 
since  this  is  often  the  period  when  sedentary 
habits  are  established. 

EXERCISE 

JUST  as  children  automatically  get  the 
proper  amount  of  sleep,  if  they  are  given  half 
a  chance,  so  will  they  of  their  own  accord  take 
the  proper  amount  of  exercise.  It  only  remains 
for  us  not  to  restrain  them.  Of  course,  there 
are  occasional  exceptions  to  this  rule. 

The  chief  restraint  that  we  are  apt  to  place 
upon  them  during  the  early  months  is  that 


EXERCISE  59 

of  clothing.     If  this  is  loose  enough  to  per-  Freedom  of 
mit  of  free  movements  of  the  arms  and  legs, 
baby  will  get  exercise,   especially  when  he 
cries.     At  the  same  time  he  should  have  half  Clothing. 
an  hour  night  and  morning  when  his  diapers 
and  socks  are  removed  and  he  is  laid  upon  First  Year, 
the  bed  in  a  room  of  the  proper  temperature, 
free  of  draughts.     There  he  kicks  and  plays 
to  his  heart's  content  and  develops  his  mus- 
cles.    When  he  has  learned  to  creep  and  later  Second 
to  walk,  ^t  w^nld  seem  as  though  he  would 
wear  himself  out,  he  keeps  at  it  so  constantly. 
There  is  no  danger  of  this,  however,  if  he  is 
not  overpersuaded  and  if  he  has  the  proper 
number  of  naps  and  sleeping  hours. 

After  the  second  year,  the  baby  carriage  The  Baby 
habit  is  a  common  restraint  in  the  city.  Baby  Habit, 
has  been  wheeled  about  all  through  infancy 
and  it  is  difficult  to  change  to  walking,  but 
we  will  not  make  this  mistake  if  we  realize 
that  he  needs  this  exercise.     On  the  other 
hand,  long  walks  on  the  street  to  the  point 
of   fatigue    are,  of   course,  unnecessary  and 
harmful.     In  the  country  a  shovel  and  a  dirt  After  the 
or  sand  pile  will  be  sufficient  incentive  to  ex-  Year, 
ercise.     As  a  matter  of  fact  country  children 


60  THE    HEALTHY   BABY 

usually  get  enough  exercise  from  this  age  on, 
if  you  turn  them  out  in  the  open  and  let  them 
play  from  morning  until  night,  except  for  the 
naps.  The  city  child  often  stores  away 
enough  good  health  from  his  summer  outing 
to  last  him  throughout  the  winter. 

After  five  years  of  age,  the  matter  of  exer- 

cise is  occasionally  a  problem  ;   for  there  are 

those  children  who  have  been  kept  too  closely 

to  the  mother  or  nurse,  or  who  have  been 

brought  up  to  fear  dirt,  or  have  a  natural  in- 

clination to  sedentary  things,  such  as  sew- 

The  CMd  ing  or  reading.     Every  inducement  in  the 

not°Want  waY  °f  making  outdoor  life  attractive  should 


to  go  Out.  ke  offers  jf  this  method  is  not  successful 
in  getting  the  child  to  like  it,  he  should  be 
compelled  to  go  out.  I  am  aware  that  the 
city  mother  may  dread  sending  her  children 
into  the  streets  and  parks,  and  the  country 
mother  may  fear  the  contact  with  her  neigh- 
bor's children,  but  if  she  has  brought  her 
children  up  to  obey  her  and  wish  for  her  ap- 
proval of  their  acts,  she  need  not  fear  asso- 
ciation with  other  children.  At  any  rate,  I 
would  vote  for  the  outdoor  exercise  in  spite 
of  risky  associations. 


EXERCISE  61 

As  the  children  get  old  enough,  especially 
girls,  it  is  well  that  they  become  interested 
in  competitive  outdoor  games,  and  in  this 
way  pave  the  road  to  a  lifelong  fondness  for 
exercise.  Gymnasium  work  in  the  winter  and 
the  indoor  sports  are  invaluable  paths  to 
good  health  in  the  cities. 

The  delicate  child  should  have  his  exercise  Exercise 
regulated  for  him.     Most  excellent  work  is  Delicate 
now  being  done  in  calisthenics  for  delicate  Child' 
children  by  those  trained  in  this  work.     A 
child  who  tires  easily  usually  has  some  par- 
ticular cause  for  it. 

Can    the    child    get    too   much   exercise?  Can  the 
There   certainly   are   active   beys   and   girls  t0o  much 
who  enter  so  enthusiastically  into  their  play  Exercise? 
that  they  come  into  the  house  perhaps  too 
tired  to  eat  or  sleep.     This  is  due  to  excite- 
ment during  play,  especially  when  they  are 
playing  with  children  older  than  themselves. 
Here,  as  in  almost  every  question  of  child- 
welfare,  moderation  is  advisable,  and  such 
children  should  be  restrained  to  a  certain 
extent. 


62  THE    HEALTHY   BABY 


TRAINING   AND   DISCIPLINE 

LACK  of  discipline  is  an  American  weakness. 
You  cannot  imagine  the  humiliation  with 
which  I  have  heard  foreign-born  mothers  of 
my  charity  patients  say,  "But  he  is  like 
the  American  child,  he  does  not  mind." 
The  Key-  A  child's  training  begins  during  his  first 
Discipline,  week,  and  unless  he  has  learned  the  meaning 
of  discipline  at  home,  where  it  is  kindly  meant, 
it  goes  hard  with  him  by  the  time  he  gets  out 
into  the  world;  for  wherever  he  is,  he  must 
stand  the  consequences  of  his  acts.  This  is 
the  keynote  of  discipline.  A  child's  naughti- 
ness is  punisLed  because,  if  it  is  allowed  to  go 
on,  he  will  not  be  happy  himself  and  he  will 
be  the  cause  of  unhappiness  in  others  —  just 
as  in  later  life  he  will  be  rewarded  at  least 
with  a  happy  conscience  if  he  does  right,  or 
will  be  punished  if  he  does  wrong. 
TOO  much  From  the  very  first  a  baby  who  is  picked 

Handling  .  ,  ,       ,       ,        . 

in  Baby-  up  every  time  he  cries  recognizes  the  lack  of 
hood'  discipline.     He  cries  to  attract  attention  - 
it  is  about  the  only  thing  he  knows  how  to 
do.     He  is  held  more  and  more  each  day  un- 
til he  ruins  his  health  by  lack  of  sleep  and 


TRAINING   AND   DISCIPLINE  63 

too  much  handling,  and  spoils  the  pleasure 
of  his  parents.  I  do  not  mean  that  he  should 
never  be  taken  up  and  held,  for  I  believe 
parents  should  enjoy  their  babies,  especially 
after  they  are  old  enough  to  take  notice  of 
their  surroundings.  But  there  is  a  happy 
medium;  if  we  play  with  the  baby  a  little 
before  his  feedings  or  during  his  afternoon 
recreation  hour,  he  will  become  accustomed 
to  being  taken  up  and  laid  down  as  we  wish, 
and  it  will  never  occur  to  him  to  expect  it  at 
any  other  time. 

There  are  several  particularly  trying  pe-  Nine 
riods  in  a  child's  training.  One  of  them  is  Ag°ena  8 
at  eight  or  nine  months  when  he  is  emphati- 
cally  insistent  upon  having  his  own  way. 
He  has  really  just  discovered  that  he  is  an 
individual  with  a  will.  He  wants  something 
on  the  table  and  grabs  for  it.  Mother  takes 
it  away  from  him  and  he  picks  up  the  next 
thing  as  quick  as  a  wink.  Mother  takes  this 
away  and  the  same  performance  is  repeated 
until  there  is  nothing  left.  Then  he  cries  un- 
til mother  gives  back  the  desired  object  in 
order  to  keep  him  quiet.  What  mother 
should  have  done  is  to  put  up  her  finger  and 


64  THE    HEALTHY   BABY 

say,  "No."  If  after  this  he  tries  it  again, 
as  he  is  liable  to  do,  his  chair  should  be  turned 
back  to  the  table  so  that  he  may  know  his 
misbehavior  has  been  punished.  It  is  won- 
derful how  soon  he  learns  to  "stop"  when 
told  to  do  so,  for  we  are  apt  to  underestimate 
his  intelligence  greatly.  X 

Anger  and  Disciplining  should  always  be  done  in  as 
have  no  pleasant  a  manner  as  possible.  Of  course, 
every  one  knows  that  the  spirit  of  anger  is 
not  part  of  discipline."  Correction  should 
also  be  done  with  a  positiveness  that  leaves 
no  doubt  in  the  child's  mind  what  his  course 
is  to  be.  Sternness  is  seldom  necessary. 
Allow  the  child  every  liberty  that  comes 
within  the  limits  of  propriety;  use  few 
"don'ts,"  but  when  the  word  is  once  said, 
enforce  it.  Make  him  happy  and  enter  into 
his  pleasures  as  enthusiastically  as  you  know 
how.  But,  when  you  tell  him  to  do  a  thing 
let  him  mind  without  any  hesitation.  Do 
not  speak  but  once.  If  he  does  not  obey  the 
first  time,  do  something  that  will  impress  his 
mind  with  the  fact  thaf  you  meant  what  you 
said  the  first  time  you  said  it  —  let  him  un- 
derstand that  your  word  is  law.  The  mother 


TRAINING   AND   DISCIPLINE  65 

who  threatens  her  children  with  punishment 
a  dozen  times  to  every  once  she  administers 
it,  is  never  obeyed.  Her  children  know  that 
she  is  apt  to  lie  twelve  times  first,  and,  being 
natural  optimists,  they  think  of  the  thirteenth 
time  when  they  will  have  to  obey  as  in  the 
far  distant  future. 

As  a  child  grows  older,  we  must  recognize  The  child's 
his  individuality.  Some  children  are  far 
more  difficult  to  manage  than  others,  but 
secretly  I  always  have  my  doubts  about  the 
parents  of  a  child  who  does  not  mind  well.  It 
requires  not  only  good  judgment,  but  a  fond- 
ness for  children,  to  attain  good  discipline 
in  one's  family.  The  rod  is  not  popular  at 
the  present  time,  I  know,  but  some  children 
still  need  it. 

The  same  kind  of  punishment  repeated 
time  and  time  again  is  often  ineffectual  in  a 
child  who  is  hard  to  manage.  A  child  who 
is  shut  in  the  closet  every  time  he  is  naughty 
soon  learns  to  amuse  himself  there,  even  to 
the  point  of  forgetting  that  he  is  being  pun- 
ished. If  we  can  manage  to  show  our  scorn 
of  his  misdeeds  in  some  unexpected  way,  it  is 
far  more  apt  to  make  an  impression  upon  him. 


66  THE    HEALTHY   BABY 

The       Above  all  do  not  punish  him  too  often.     I 
Too^re-  have  the  greatest  sympathy  for  the  child  who 
punish-  *s  const-antly  in  trouble.     Try  to  make  his 
ment.  happiness  your  object,  and  obedience  a  natu- 
ral consequence  of  your  wishes.     An  entirely 
different  tack  may  be  taken  up  when  one 
kind  of  treatment  has  been  tried  and  found 
wanting.     I  have  known  a  child  to  improve 
wonderfully  in  his  behavior  when  the  parents 
have  overlooked  his  misdeeds,  and  stopped 
all  punishment  for  a  while. 

Teasing.  Teasing  has  ruined  the  disposition  of  many 
a  child.  The  parents,  of  course,  will  not  be 
guilty  of  such  conduct,  but  older  children  in 
the  family,  or  an  uncle  or  aunt,  may  make  a 
child's  life  utterly  miserable  by  constant 
teasing.  I  have  seen  a  great  strong  brute  of 
a  man  keep  a  child  struggling  hours  for  some 
object  and  almost  allow  him  to  get  it  over 
and  over  again,  only  to  thwart  the  little 
fellow's  purpose  by  sheer  strength  just  as  he 
has  reached  his  goal. 

Truthful-       Truthfulness  and  honesty  are  not  born  in 

imagina-  every  child,  but  it  may  always  be  acquired 

on'  if  we  take  the  trouble  to  teach  it.     In  the 

first  place  never  tell  an  untruth  to  a  child 


TRAINING    AND   DISCIPLINE  67 

yourself.  If  you  make  a  practice  of  it,  he  is 
not  to  blame  for  acquiring  the  habit,  too. 
Then  never  allow  an  untruth  to  be  told  by 
him  without  letting  him  see  that  you  know  it 
is  not  the  truth.  Do  not  make  too  much  of 
it,  but  simply  correct  him  in  his  statement, 
unless  lying  has  become  a  fixed  habit.  I  do 
not  mean  that  you  should  doubt  his  word 
constantly,  for  that  leads  him  to  think  you 
expect  untruthfulness  of  him  and  he  surely 
will  not  disappoint  you  if  you  do.  Remember 
that  there  is  a  certain  age  when  the  child 
is  very  imaginative,  and  this  tendency  should 
be  encouraged,  for  imagination  is  a  very  valu- 
able trait  if  it  is  under  proper  control.  In  fact, 
I  believe  in  imaginative  stories  being  told  to 
children,  and  imaginative  events  being  de- 
scribed to  them,  both  to  encourage  the  trait 
and  to  enable  them  to  distinguish  between 
imagination  and  lying.  For  instance,  if  you 
tell  him  a  tale  about  himself  that  is  purely 
imaginative,  he  will  say,  "Is  it  a  true  story  or 
a  fooling  one,  mother?" 

Asking  questions  is  a  much  discussed  sub-  The 
ject  which  I  will  just  touch  upon.     Answer  Habit.01 
a  child's  sensible  questions  so  long  as  he  is 


68  THE    HEALTHY   BABY 

interested  enough  to  listen  to  the  answer 
and  remember  it  afterward.  The  annoying 
habit  of  a  child's  asking  one  question  after 
another  without  waiting  for  an  answer  is 
to  be  discouraged.  Always  answer  truthfully 
and  do  not  try  to  make  him  feel  that  you  are 
infallible,  for  he  will  lose  faith  when  he  finds 
you  are  not. 

Above  all  teach  a  child  to  be  happy.  Instill 
happiness  into  him  by  being  happy  in  his 
presence.  We  sometimes  hear  a  mother  say, 
"The  children  are  cross  to-day,"  when  it  is 
because  she  has  been  in  a  bit  of  an  ill  humor 
herself.  Things  have  not  gone  right  and  the 
children  have  caught  the  spirit  of  it  im- 
mediately. Allow  them  every  pleasure  that 
will  do  them  no  harm,  so  that  the  spirit  of 
joyousness  will  blossom  within  them  and 
they  will  learn  to  be  happy  even  in  adversity. 

v 


Beginning       DID  you  ever  go  into  a  home  where  every- 

Right.  thing  went   off  like   clockwork,   so   that   it 

seemed    as    though    the    household    moved 

smoothly    on    of    its    own    accord?    Every 

event  in  the  day  has  its  time  and  place.     Well, 


DAILY   ROUTINE  69 

that  is  due  to  a  good  daily  routine.  Even 
such  a  model  household  as  this  is  terribly 
upset  when  a  new  baby  comes  into  it, 
but  the  executive  mother,  as  soon  as  she  is 
strong  enough,  will  set  the  machinery  going 
right  again.  The  first  thing  she  does  is  to 
plan  out  baby's  daily  routine.  The  feeding 
times  must  first  be  adjusted,  for  these  come 
at  definite  intervals  which  divide  the  day 
into  sections.  When  we  have  decided  upon 
the  length  of  time  between  feedings  necessary 
for  this  particular  baby,  —  two,  two  and  one 
half,  or  three  hours,  and  it  is  usually  three 
hours  (see  "Feeding"),--  we  start  the  first 
feeding  at  a  given  time,  say  six  o'clock  in 
the  morning,  thus  beginning  the  day  right. 
This  will  give  the  nurse  or  mother  time  to 
dress,  have  her  breakfast,  give  the  baby  a 
bath,  and  even  make  up  the  bottle-fed  baby's 
feedings  before  nine  o'clock,  when  the  next 
feeding  is  due. 

After  the  nine  o'clock  feeding,  the  baby  is  The  Day's 

.1  .....  ,  .  Schedule. 

taken  out  for  his  airing  and  morning  nap. 
If  there  is  a  yard  or  fire  escape  available  for 
this  part  of  the  day's  program,  the  mother 
has  this  interval  free  for  other  duties.  At 


70  THE    HEALTHY   BABY 

twelve  comes  another  bottle,  followed  by  the 
mother's  luncheon  and  baby's  afternoon  nap 
and  airing.  At  three  there  is  another  feeding, 
followed  by  an  interval,  during  which  baby 
has  his  recreation  hour,  lying  on  the  bed  or 
sitting  on  the  floor  at  play  by  himself.  During 
the  hour  before  six  he  may  be  held  in  the  lap 
or  entertained,  if  one  has  the  inclination,  or  if 
he  gets  restless  and  fussy  by  himself.  After 
the  six  o'clock  bottle,  he  goes  to  bed  for  the 
night  and  is  not  taken  out  of  bed  again  until 
morning,  except  for  his  feedings.  The  mother 
or  nurse  then  has  her  evenings  free  to  do 
many  things  she  wants  to  do.  I  have  heajrd 
mothers  say  that  they  never  realized  thefe 
was  a  baby  in  the  house  after  they  adopted 
some  routine  of  this  sort.  The  routine  has 
to  be  changed  with  changed  conditions,  but 
I  have  outlined  this  one  which  has  proven 
very  useful  to  many  of  my  patients. 
Necessity  As  the  child  grows  older,  the  daily  program 
ingThe  has  to  be  changed,  the  mother  having  mean- 
white  learned  to  develop  the  routine  that 
Grows  serves  her  best.  She  should  remember,  how- 

Older. 

ever,  that  routine  is  meant  to  aid  her  in  per- 
forming her  duties  in  the  easiest  way  as  well 


HABITS  71 

as  to  bring  up  baby  to  be  orderly  and  sys- 
tematic. She  must  not  become  a  slave  to 
routine,  so  that  the  day's  work  is  a  drudge, 
for  the  best  of  rules  are  meant  to  break 
when  the  occasion  demands  it.  For  in- 
stance, when  the  child  reaches  the  age  when 
four  meals  a  day  are  necessary,  the  mother 
very  likely  reads  a  diet  list  which  prescribes 
breakfast  at  six,  a  lunch  at  eleven,  dinner  at 
two,  and  supper  at  six.  Her  own  meals  must 
come  in  between  these  hours,  so  that  there  is 
some  meal  being  cooked  in  the  household 
nearly  all  day  long.  How  much  simpler  it  is 
to  have  baby's  breakfast  and  luncheon  at 
the  family's  regular  meal  hours,  with  a  bottle 
at  10  P.M.,  to  make  up  the  four  feedings.  In 
this  way  the  mother  makes  a  routine  which 
is  easiest  for  her  and  equally  as  good  for  the 
baby. 

HABITS 


As  I  have  said,  a  child  is  a  creature  of 
habits,  and  so  are  we  all.  Let  us  begin  with 
him  early  and  make  the  habits  good  ones. 
Train  him  to  do  the  right  things  from  the 
start.  The  habit  of  regularity,  the  habit  of 
cleanliness  and  the  habit  of  happiness  may 


72  THE    HEALTHY   BABY 

be  started,  and  are  even  best  started,  in 
infancy.  The  habit  of  the  bodily  functions, 
the  habit  of  orderliness,  the  habit  of  obedience 
are  developed  as  he  grows  older. 

Cleanliness       Habits  of  cleanliness  are  cultivated  by  con- 
Orderiiness.  stant  watchfulness.     There  is  no  need  of  a 
child's  covering  himself  with  mud  as  soon  as 
he  has  been  dressed,  nor  of  smearing  him- 
self with  food  as  he  eats.     The  older  child 
develops    habits    of    orderliness    by    being 
taught  to  hang  up  his  clothes  as  they  are 
taken   off,   and   by  putting  his   toys   away 
when  he  is  through  with  his  play.     He  is 
taught  to  pick  up  after  himself  as  he  goes 
along,  instead  of  leaving  one  grand  clutter 
to  be  cleaned  up  after  he  has  gone  to  bed. 
Proper       As  to  the  bodily  functions,  if  we  keep  his 
^the  diapers  dry  and  clean  in  infancy,  he  learns  to 

Function*  warn  us  DV  crymg  when  he  is  wet  and  un- 
comfortable. If,  as  he  grows  older,  we  put 
him  upon  the  chair  at  regular  intervals,  he 
learns  to  make  the  function  of  urination  a 
voluntary  one  and  under  the  control  of  the 
will.  So,  at  eight  months  or  thereabouts, 
put  him  on  the  chair  every  hour  while  he  is 
awake  and  gradually  lengthen  these  intervals 


HABITS  73 

until  at  a  year  he  will  reward  you  for  your 
labor  by  keeping  dry  all  day  long.  Take 
him  up  at  night  when  you  go  to  bed  (giving 
him  dry  suppers)  and  he  will  form  the  habit 
of  not  wetting  the  bed  as  soon  as  he  is  old 
enough  to  have  his  ten  o'clock  nursing  or 
bottle  discontinued.  The  habit  of  the  bowel 
functions  I  have  spoken  of  under  that  head- 
ing. 

There  are  bad  habits  that  baby  acquires  The  "Baby 
himself,  and  there  are  bad  habits  which  we 
deliberately  bestow  upon  him.  In  infancy 
the  most  common  of  these  is  sucking.  The 
use  of  the  "Baby  Comfort"  or  nipple  is  never 
a  habit  he  picks  up  himself.  It  is  taught 
him  by  his  elders,  who  show  little  sense  in 
compelling  him  to  acquire  a  habit  which 
is  injurious.  It  is  natural  for  the  baby  to 
get  his  food  by  sucking,  but  the  continual 
sucking  deforms  the  mouth  and  jaws  and  is 
the  chief  cause  of  protruding  teeth  in  adults. 
That  it  also  causes  adenoids  and  enlarged 
tonsils  I  am  firmly  convinced.  Finger  suck-  Finger 
ing  and  sucking  of  the  sheet  and  clothing  the 
child  learns  himself,  and  it  is  still  more  in- 
jurious and  more  apt  to  be  continued  through 


74  THE    HEALTHY   BABY 

the  second  and  third  years.  Even  sucking  of 
the  lips  sometimes  becomes  a  habit.  These 
sucking  habits  require  different  treatment 
according  to  the  age  of  the  child  and  the 
form  the  habit  has  taken.  Babies  may  be 
broken  of  finger  sucking  by  putting  on 
mittens  or  pinning  the  sleeves  to  the  dress 
or  bed  clothes.  Older  children  may  wear 
celluloid  gloves  for  a  few  nights.  Sucking 
of  the  sheet  or  pillow  case  may  be  remedied  by 
taking  that  article  away  from  the  child's  bed 
altogether.  The  best  way  to  treat  any  bad 
habit  is  to  put  a  stop  to  it  at  its  inception. 

Some  children  cannot  go  to  sleep  without 
pulling  the  ear  or  twisting  a  curl  of  hair 
about  the  fingers.  These  habits  are  not  as 
harmful  as  some  others,  but  it  is  well  to  check 
them  lest  worse  ones  follow. 

The  im-       Nail  biting  in  itself  does  no  harm  except 

^fseif-  to  disfigure  the  nails,  but  the  very  notion 

mastery.  fa&t  a  cj^{\^  ge^s>  that  he  has  a  habit  which 

he   cannot   stop,    is   harmful   in   itself.     He 

should  be  persuaded  to  give  it  up  by  rewards, 

or  otherwise,  so  that  he  may  acquire  a  sense 

of  self-mastery.     This  knowledge  that  he  has 

himself  in  control  is  a  wonderful  trait  to  ac- 


HABITS  75 

quire,  and  if  more  children  were  taught  it, 
fewer  young  men  and  women  would  fall 
by  the  wayside  when  more  serious  tempta- 
tions present  themselves. 


PART   III 
COMMON  AILMENTS 


THE  SICK   ROOM 
WE  are  not  all  situated  so  that  the  ideal  Arrange- 

.   ,  .  MM-,  L    ment  of  the 

sick  room  is  a  possibility.  Apartment  sick  Room, 
dwellers  especially  have  to  be  content  with  as 
close  an  approach  to  it  as  is  practical  under 
the  circumstances.  It  is,  however,  absolutely 
necessary  to  give  up  one  room  exclusively  to 
the  sick  child  at  whatever  sacrifice  it  requires 
—  that  is,  if  a  prolonged  sickness  is  antici- 
pated. This  should  be  the  quietest,  sunniest, 
airiest  room  in  the  house,  even  though  you  have 
to  take  a  room  which  is  not  ordinarily  used  for 
a  sleeping  room.  The  chief  consideration  is 
the  matter  of  airing.  Under  no  circumstances 
should  we  select  a  room  which  cannot  be 
aired  while  the  patient  lies  in  bed,  and  at  the 
same  time  be  well  heated.  It  is  not  necessary 
to  take  down  the  pictures  and  hangings  and 
take  up  the  rugs,  but  this  may  be  done  if  one 
wishes.  It  is  best  to  have  the  bric-a-brac 
and  knickknacks  removed,  and  the  table  and 
bureau  top  swept  clean  of  its  usual  comple- 
ment of  articles,  so  that  the  furniture  may  be 
used  for  medicines  and  other  paraphernalia  of 
sickness.  The  bed  should  be  so  placed  that 
79 


80  THE    HEALTHY   BABY 

the  sun  will  not  shine  directly  into  the  patient's 
eyes,  and  it  should  also  be  out  of  the  direct 
line  of  a  draught  when  the  windows  are  open. 
This  being  impossible,  a  screen  may  be  used. 
The  Sick  The  sick  room  conduct  is  of  the  greatest 
Conduc™  importance.  All  should  be  quiet  and  orderly 
and  systematic.  No  visitors  are  allowed  until 
permission  has  been  granted  by  the  physician. 
Engaging  in  prolonged  conversation  even  in 
an  undertone  is  very  disturbing  to  the  child. 
Never  more  than  two  persons  are  allowed  in 
the  room  at  the  same  time,  and  unless  some 
particular  duty  relative  to  the  treatment 
requires  it,  one  is  all  that  is  necessary.  If 
there  is  a  trained  nurse  in  attendance,  do  not 
hamper  her  with  any  interference.  She  can 
gain  the  child's  confidence  more  quickly  if 
she  is  given  a  few  hours  alone  with  him  than 
she  can  if  you  are  there.  Where  there  is 
no  nurse,  one  person  should  be  responsible 
for  all  that  goes  on  in  the  sick  room.  She 
should  be  relieved  of  her  duties  for  her 
sleep,  as  she  is  not  competent  to  attend  to 
the  patient  properly  when  she  is  tired  out  for 
want  of  rest. 

In  contagious  diseases,  the  person  in  attend- 


CONTAGIOUS   DISEASES  81 

ance  should  not  leave  the  room,  but  should  in  Case  of 
have  her  bed  there,  or,  better  still,  in  an  Contagion- 
adjoining  room.  Where  two  nurses  are  re- 
quired, a  second  room  is  indispensable.  All 
dishes  should  be  kept  separate  and  washed  in 
the  room  if  possible.  All  clothes,  towels,  and 
the  nurse's  outer  clothing  should  be  soaked 
in  a  solution  of  carbolic  acid,  one  half  ounce 
to  a  gallon  of  water,  before  they  leave  the 
room  to  be  laundered.  No  visitors  are 
allowed  —  even  the  family  should  not  come 
into  the  room  for  fear  of  carrying  the  con- 
tagion about  the  house. 

CONTAGIOUS    DISEASES 

IT  is  odd  that  with  the  present  popularity 
of  medical  lay  articles,  the  writers  have  not 
shown  more  interest  in  teaching  the  public 
how  to  avoid  the  common  contagious  diseases. 
Such  information  would  certainly  be  more 
helpful  than  the  pages  devoted  to  the  prob- 
lematical causes  of  infantile  paralysis  and 
other  subjects  which  have  not  yet  been  settled 
among  the  members  of  the  medical  profes- 
sion themselves. 

In  the  first  place,  never  expose  the  child 


82  THE    HEALTHY   BABY 

Exposure  to  any  contagious  disease  in  order  that  he 

Contagious  may  have  it  once  and  done  with  it.   Even  the 

Diseases  so_caueci  simple  children's   diseases,  such  as 

to  be 

Avoided,  measles  and  whooping  cough,  have  a  death 
rate  that  is  appalling.  Nor  should  you  allow 
politeness  to  stand  in  the  way  when  there 
is  any  danger  of  your  own  child  getting  a 
contagious  disease.  This  may  sound  like 
unnecessary  advice,  but  I  have  known  parents 
to  say  they  could  not  offend  their  friends 
by  refusing  to  see  them  when  there  was  a 
contagious  disease  in  the  family  from  which 
the  caller  came.  Never  take  your  child  into 
a  household  where  there  is  any  sickness 
whatever,  for  it  may  turn  out  to  be  a  conta- 
gious illness  no  matter  how  it  begins. 

Each  contagious  disease  has  a  special  mode 
of  invading  your  family  and  there  is  a  special 
way  of  preventing  its  invasion  ;  so  I  will  take 
up  the  important  considerations  of  each 
disease,  one  at  a  time. 

Scarlet  Scarlet  fever  is  among  the  most  dreaded 
diseases  of  childhood,  and  rightly  so.  It  is 
also  one  of  the  most  contagious,  but  fortu- 
nately the  danger  of  contagion  is  not  so  great 
during  the  early  stages.  I  have  known  a 


CONTAGIOUS   DISEASES  83 

child  to  sleep  in  the  same  bed  with  another 
child  coming  down  with  scarlet  fever  and  not 
catch  it.  From  this  it  is  evident  that  we 
should  remove  the  already  exposed  child 
away  from  the  contagion  as  soon  as  we  dis- 
cover it,  no  matter  how  late  that  may  be.  In 
scarlet  fever  there  is  a  chance,  at  least,  that 
he  has  not  contracted  it  from  this  one  early 
exposure.  However,  the  disease  is  caught 
early  through  the  vomitus,  and  consequently 
it  is  safer  to  avoid  a  vomiting  child  in  the 
streets,  cars,  and  public  places  anywhere. 
Unfortunately  scarlet  fever  is  contagious 
for  a  long  while  after  it  has  actually  set  in. 
As  long  as  there  is  any  peeling  or  discharge 
from  the  ears  or  nose,  the  danger  of  contagion 
is  still  present.  Everything  with  which  the 
scarlet  fever  patient  has  come  in  contact 
during  his  illness  may  be  regarded  as  a  source 
of  contagion  even  months  and  years  after 
the  illness. 

Measles,  on  the  contrary,  is  just  as  con-  Measles. 
tagious  in  its  early  stages,  when  the  eyes  and 
nose  are  running  and  four  days  before  any 
eruption  has  appeared,  as  it  is  at  the  height 
of  the  disease.     This  is  why  the  whole  family 


84  THE    HEALTHY    BABY 

is  liable  to  come  down  with  it  when  one 
member  of  the  family  brings  it  home.  Unless 
the  physician  is  called  during  this  stage,  the 
disease  is  not  diagnosed  until  the  eruption 
appears,  when  it  is  too  late  to  prevent  the  rest 
of  the  family  from  getting  it.  This  is  also 
another  reason  why  we  should  keep  our 
children  away  from  any  one,  especially  another 
child,  who  has  a  cold  in  the  head.  I  have 
had  the  misfortune  to  treat  for  measles  ten 
children  in  different  families  who  had  all 
attended  a  birthday  party  at  which  was 
present  a  child  who  was  in  the  catarrhal 
stage  of  measles,  no  eruption  having  made 
its  appearance  in  the  child  when  he  went  to 
the  party.  His  mother  thought  he  simply 
had  a  bad  cold  and  let  him  go.  It  is  needless 
to  say  that  that  mother  was  not  popular  in 
that  particular  set  for  a  long  while  afterward. 
Diphtheria.  Diphtheria,  I  am  happy  to  say,  is  one  of  the 
contagious  diseases  which  the  physician  can 
prevent  absolutely  after  the  child  has  been 
exposed.  An  immunizing  dose  of  diphtheria 
antitoxin  will  always  make  it  a  certainty 
that  a  child  will  not  get  this  dreaded  disease 
in  spite  of  definite  exposure  to  it.  There  are 


CONTAGIOUS   DISEASES  85 

no  dangers  in  giving  antitoxin  in  its  present- 
day  perfection,  no  matter  how  delicate 
the  child  may  be.  Sometimes  there  is  a 
slight  discomfort  following  its  use,  but  this 
may  be  disregarded  when  we  consider  what 
a  dreadful  disease  this  was  before  the  days 
of  antitoxin.  A  person  may  have  diphtheria 
many  times,  in  fact  some  people  have  the 
habit.  I  know  a  physician  who  has  had  it 
fourteen  tunes. 

Whooping  cough  is  not  so  contagious  as  whooping 
some  of  the  other  infections,  but  it  is  fully  as 
dangerous  once  it  is  acquired.  It  cannot 
be  carried  by  the  third  person,  and  one  ex- 
posure may  not  be  enough  to  cause  it.  The 
person  having  it  is  a  source  of  contagion  as 
long  as  he  has  a  paroxysmal  cough,  this  period 
varying  from  six  weeks  to  three  months.  The 
death  rate  from  this  so-called  benign  disease 
is  as  great  in  New  York  City  as  that  from 
scarlet  fever,  diphtheria,  and  measles  com- 
bined. Therefore,  keep  your  child  away 
from  whooping  cough,  especially  your  baby, 
for  it  is  most  fatal  among  children  under  a 
year.  It  is  well  to  keep  children  away  from 
anybody  who  has  a  cough.  Once  acquired, 


86  THE    HEALTHY   BABY 

do  not  become  pessimistic  and  think  whoop- 
ing cough  must  "run  its  course."  Your 
physician  can  do  something  to  prevent  the 
severity  of  the  disease,  and  he  can  often 
shorten  its  duration.  He  can  usually  prevent 
the  complications  which  are  the  dangerous 
phases  of  the  disease. 

Neither  mumps,  chicken  pox,  nor  German 
measles  is  a  dangerous  disease  if  the  child 
is  well  cared  for  during  its  run. 

Smallpox.  Smallpox  may  be  absolutely  prevented  by 
vaccination,  provided  the  vaccination  takes 
properly  and  provided  it  is  done  often  enough. 
I  have  no  sympathy  with  anti-vaccinationists. 
They  do  not  recognize  the  fact  that  before 
vaccination  was  compulsory,  epidemics  of 
smallpox  swept  over  the  country,  leaving 
one  third  of  the  population  dead  and  many 
others  marked  for  life  with  the  pits  of  this 
most  dreaded  of  diseases.  It  was  with  the 
utmost  satisfaction  that  the  medical  pro- 
fession in  recent  years  witnessed  the  deliberate 
exposure  to  smallpox  of  a  prominent  anti- 
vaccinationist  of  Boston.  He  had  claimed 
that  there  was  no  danger  to  the  unvaccinated 
from  the  disease.  He  acquired  smallpox  at 


CONTAGIOUS   DISEASES  87 

the  prescribed  time  and  barely  escaped  with 
his  life.  Every  healthy  child  should  be 
vaccinated  before  he  is  six  months  of  age. 
He  should  subsequently  be  vaccinated  once 
in  five  years  and  when  he  is  exposed  to  the 
disease.  There  are  no  dangers  at  the  present 
time  from  vaccination  if  it  is  done  properly 
and  the  wound  kept  clean  until  it  has  healed. 
Any  serious  trouble  always  comes  from  the 
lack  of  these  precautions. 

Colds  and  coughs,  sore  throats,  and  tonsil-  Coughs 
litis  are  certainly  contagious.  Keep  your  chil- 
dren away  from  people  who  have  any  of  these 
ailments.  However,  the  better  your  child's 
hygiene  and  the  better  his  general  condition, 
the  less  liable  is  he  to  become  infected  if 
exposed  to  them.  Kissing  is  an  unfortunate 
custom  of  civilization,  for  it  spreads  disease, 
especially  coughs  and  colds.  It  would  hardly 
seem  necessary  for  parents  to  be  constantly 
on  then-  guard  to  prevent  the  kissing  of  their 
children  by  friends  and  strangers,  but  such 
is  the  case.  Public  drinking  cups  are  the 
cause  of  many  illnesses  and  the  common 
cup  at  school  should  never  be  allowed.  (See 
"Colds.") 


SS  THE    HEALTHY   BABY 

The  MI.S-      Mosquitoes  are  the  sole  cause  of  malaria. 

qTheF!yd  IQ  malarial  districts  take  the  most  rigid 
precautions  to  prevent  mosquito  bites.  The 
much-abused  house  fly  deserves  his  reputa- 
tion. He  is  the  carrier  of  typhoid  fever, 
bowel  troubles,  possibly  infantile  paralysis, 
and  other  infections. 

School  Schools  are  the  chief  source  of  the  prin- 
cipal contagious  children's  diseases,  as  the 
statistics  show  that  these  diseases  are  most 
rife  during  the  school  months  and  in  children 
of  the  school  age.  In  our  large  cities  the 
public  schools  are  well  inspected  medically. 
It  is  our  duty  to  our  children  to  demand  proper 
medical  supervision  in  the  private  school, 
also,  before  we  place  them  in  one. 

Tubercu-       Tuberculosis  is  a  contagious  disease.     It 

Consumi>  nas  so  long  been  considered  an  inherited 
tlon>  disease  that  the  general  public  find  it  hard 
to  get  the  old  notion  of  transmission  from 
parent  to  offspring  out  of  their  minds.  To 
be  sure  the  tendency  may  be  inherited,  that  is, 
a  poor  and  weakened  constitution,  but  this 
may  be  overcome  with  comparative  ease 
under  the  proper  conditions.  Children  from 
a  tuberculous  family  should  have  especial 


CONTAGIOUS   DISEASES  89 

care  paid  to  fresh  air  and  diet  from  the 
moment  they  are  born.  They  should  be  kept 
in  robust  health  by  fresh  air  night  and  day, 
and  by  having  the  diet  a  nourishing  one. 
The  vigilance  of  the  parents  should  never 
be  relaxed  in  either  direction.  On  the  other 
hand,  exposure  to  tuberculosis  should  be 
avoided.  By  this  I  do  not  mean  that  children 
will  acquire  tuberculosis  upon  one  exposure, 
but  that  they  should  not  live  with  tuberculous 
people  nor  come  in  contact  with  them  daily. 
For  this  reason  it  would  be  well  if  the  general 
public  looked  upon  tuberculosis  as  a  conta- 
gious disease.  Care  should  be  taken  that  the 
nurse  has  no  cough  and  has  not  been  in 
contact  with  people  suffering  with  tubercu- 
losis. 

I  believe  that  many  cases  of  tubercu- 
losis in  children  come  from  living  in  houses 
or  apartments  where  consumptives  have 
formerly  lived.  When  we  realize  how  many 
families  move  into  a  house  whose  former 
occupants  are  not  known  to  them,  it  is 
only  to  be  wondered  at  that  this  disease  is 
not  spread  even  more  than  it  is.  I  believe 
milk  to  be  a  source  of  tuberculosis  in  spite 


90  THE    HEALTHY   BABY 

Milk  as  a  of   the   fact   that   certain   authorities   have 

Cause  of 
Tul)erculoBis. 


denied   this   mode   of   transmission.     In   no 


other  way  can  we  explain  some  of  the  cases 
of  tuberculosis  in  children.  Therefore,  all 
milk  used  in  making  infants'  foods,  as  well  as 
milk  for  older  children,  must  be  from  tuber- 
culin-tested cows.  Since  an  infant  so  often 
depends  entirely  upon  milk  for  his  suste- 
nance, this  is  more  important  in  infancy  than 
at  any  other  age. 

FEVER 

HOW  to  Tell  CHILDREN  get  fever  very  easily,  so  that  this 
symptom  has  not  so  much  significance  in  a 
child  as  in  the  adult.  Fever  often  goes  as 
quickly  as  it  comes.  It  is  usually  easy  to 
tell  whether  or  not  a  child  has  fever  by  feeling 
of  the  body  underneath  the  clothing  and  by 
his  flushed  face  and  glistening  eyes.  It  does 
not  seem  necessary  for  mothers  to  have 
thermometers,  for  in  my  experience  these  have 
been  a  cause  of  worry  without  being  of  any 
particular  benefit.  The  untrained  observer 
is  not  able  to  judge  correctly  the  significance 
of  the  different  degrees  of  fever.  A  high 
fever  often  serves  to  make  the  mother  un- 


FEVER  91 

necessarily  nervous  when  there  is  no  cause 
for  alarm,  and  a  low  temperature  may  occur 
in  a  child  who  is  dangerously  ill.  It  is 
enough,  therefore,  for  her  to  know  that  there 
is  a  fever,  and  this  knowledge  she  may  gain 
by  her  sense  of  touch. 

With  the  onset  of  fever  it  is  usually  safe  to  what  to  do 
administer  a  cathartic,  stop  food,  and  give  an  Fever!e  C 
alcohol  friction  bath  in  the  following  manner : 
The  clothing  is  entirely  removed  and  a  dry 
sheet  or  blanket  wrapped  around  the  child. 
One  part  is  exposed,  say  an  arm  or  the  chest, 
and  wet  with  equal  parts  water  and  alcohol. 
This  is  then  rubbed  briskly  but  lightly  with 
the  hand  until  it  has  dried.  It  is  moistened 
again  and  the  same  process  repeated,  the 
whole  body  being  gone  over  back  and  front  in 
this  way.  A  half  hour  is  allowed  for  the 
entire  bath.  Do  not  dry  with  a  towel  or 
cloth.  It  is  the  cooling  during  evaporation, 
together  with  the  friction,  which  brings  the 
blood  to  the  surface,  that  takes  down  the 
fever. 

Plenty  of  water  to  drink  may  be  allowed 
if  there  is  not  excessive  vomiting.  In  fact 
cold  water  helps  to  take  down  the  fever  and 


92  THE    HEALTHY  BABY 

dilute   any   poisonous   products   within   the 
body. 

If  the  mother  has  not  controlled  the  fever 
within  twelve  hours,  or  at  least  made  sure 
of  the  cause  of  it  so  that  she  knows  she  can 
control  it,  she  should  not  take  the  responsi- 
bility of  treating  the  child  further  herself. 

COLDS  AND  COUGHS 

HOW  to  THE  best  way  to  treat  colds  is  to  prevent 
them.  There  is  no  necessity  of  a  child's  hav- 
ing a  cold  most  of  the  time,  even  though  he 
is  exposed  to  the  infection  through  adults 
who  have  colds.  His  physical  condition 
should  be  so  healthy  that  he  resists  the  in- 
fection when  he  is  exposed  to  it  (for  colds 
are  contagious),  and  he  should  never  acquire 
The  a  cold  of  his  own  accord.  This  physical 
condition  involves  the  so-called  process  of 
"hardening."  It  means  fresh  air  every  hour 
of  the  day,  winter  and  summer.  It  means 
avoiding  overexposure,  direct  draughts,  and 
wet  unprotected  feet.  It  means  getting 
the  skin  to  react  promptly  and  properly  to 
different  changes  of  temperature  by  correct 
clothing  and  by  cold  baths.  It  means  the 


COLDS   AND   COUGHS  93 

right  diet  and  proper,  sufficient  nourishment. 
It  means  plenty  of  sleep  and  an  orderly  rou- 
tine of  existence.  It  means  that  the  child 
must  be  free  from  adenoids  and  enlarged  ton- 
sils (abnormalities  which  I  have  discussed 
under  their  respective  headings).  If  it 
is  worth  while  to  prevent  our  children 
from  having  colds,  then  we  must  work, 
and  work  intelligently,  to  do  all  these  things 
right. 

There  is  no  doubt  about  it  that  the  warm  other 
steam-heated  apartment,  with  the  dry  air 
which  steam  heat  gives,  dries  out  the  mucous  tlon8' 
membrane  or  lining  of  the  nose  and  air  pas- 
sages so  that  they  are  susceptible  to  infec- 
tion and  colds.  I  would  recommend  placing 
a  jar  of  water  on  every  radiator  so  that  the 
air  may  be  moistened  somewhat  to  prevent 
this  error  in  artificial  heating.  I  would  also 
recommend,  where  steam  heat  is  used,  that 
the  twelve  to  fourteen  hours  of  sleep  should 
take  place  in  an  unheated  room,  no  matter 
how  cold  the  weather  may  be.  Turn  off  the 
radiator  as  soon  as  the  child  is  in  bed  and 
open  the  windows,  the  child  being  warmly 
clad  for  the  night.  If  you  have  done  all 


94  THE   HEALTHY   BABY 

these  things  and  done  them  right,  your  child 
will  not  have  continual  colds,  as  I  have  proved 
to  my  satisfaction  over  and  over  again. 
Colds  due  Where  a  child  has  been  removed  from  one 
iiTciimate  Part  °f  the  country  to  another,  he  may  not 
be  able  to  throw  off  the  new  variety  of  con- 
tagious colds  that  are  rampant  in  the  new 
climate,  even  though  he  is  in  good  enough 
physical  condition  to  resist  those  infections 
where  he  has  come  from.  This  is  because  he 
has  formed  a  resistance  (or  acquired  immu- 
nity) from  the  bacteria  in  his  own  country 
but  is  overwhelmed  by  the  new  variety  of 
germs  in  the  next  place  he  goes  to.  He  has 
not  become  acclimated. 
The  Treat-  A  cold  once  acquired  needs  to  be  handled 

ment  of  a  i  T 

Cold,  properly.  I  cannot  give  you  any  one  treat- 
ment for  all  kinds  of  colds,  for  there  is  none 
such.  I  would,  however,  advise  against 
overdressing  the  child  and  the  use  of  flannel 
about  his  chest  and  throat.  I  would  most 
certainly  not  omit  the  bath.  I  would  be 
still  more  persistent  about  the  child's  having 
his  full  supply  of  fresh  air.  In  good  weather 
I  would  not  keep  him  in  the  house  for  a  cold, 
unless  he  has  a  fever. 


CROUP  95 

Sore  throats  are  dangerous  things  to  dally  Sore 
with,  for  it  is  very  difficult  for  any  one  un- 
skilled  in    throat   examinations   to   tell   the 
difference  between  tonsillitis  and  diphtheria. 

Coughs  are  often  due  to  the  same  causes  Coughs— 
as  colds.  There  are,  however,  other  causes  causes  and 
which  we  must  consider.  Errors  in  diet  are 
particularly  liable  to  cause  coughs,  as  are 
adenoids  and  enlarged  tonsils.  I  have  chil- 
dren under  my  care  that  develop  a  wheezy 
cough  whenever  they  overeat  or  " stuff,"  or 
when  they  eat  certain  articles  of  food  which 
have  been  prohibited.  A  chronic  cough 
should  never  be  allowed  to  go  on,  and  a  child 
who  has  many  coughs  throughout  the  winter 
should  have  a  thorough  overhauling  to  find 
the  cause.  Tuberculosis  is  always  lying  in 
wait  for  the  child  with  the  chronic  cough, 
particularly  after  an  acute  illness,  such  as 
pneumonia,  measles,  whooping  cough,  and 
other  children's  diseases. 

CROUP 

CROUP  is  a  spasmodic  contraction  of  the 
larynx  or  air  passage  which  may  occur  dur- 
ing the  course  of  any  ordinary  cold.  Some 


96  THE    HEALTHY   BABY 

Croup—  children,  and  even  all  the  children  in  certain 


Tnd  families,  are  prone  to  have  croup  whenever 


Symptoms.  faey  nave  a  Cold,  while  others  never  have  it. 
The  child  perhaps  has  had  a  cold  through 
the  day  and  goes  to  bed  in  a  fairly  comfort- 
able condition.  Suddenly  he  awakens  and 
sits  up  gasping  for  breath.  The  breathing  is 
slow,  noisy,  and  labored,  and  he  is  in  great 
distress.  There  may  or  may  not  be  a  sharp, 
distinctive,  brassy,  barking  cough.  The  ex- 
citement which  the  condition  causes  in  those 
about  him  only  increases  his  symptoms. 
Untreated,  this  condition  continues  three 
or  four  hours,  when  his  fatigue  causes  the 
spasm  to  relax  and  he  goes  off  to  sleep.  If 
it  lasts  longer  than  this,  our  suspicions  should 
be  aroused  that  we  are  not  dealing  with  ordi- 
nary croup,  but  with  diphtheria,  or  some 
more  dangerous  condition.  This  is  also  true 
of  "  croup"  developing  in  the  daytime.  A 
child  never  dies  of  uncomplicated  spasmodic 
croup,  so  even  in  his  distress  we  should  be 
consoled  with  the  fact  that  he  is  in  no  danger, 
provided  the  diagnosis  is  correct.  The  next 
day  the  cold  may  be  as  it  was  the  day  before, 
and  again  after  he  has  gone  to  bed  the  brassy 


CROUP  97 

cough  develops  and  the  same  distressing  scene 
takes  place. 

The  treatment  during  the  attack  consists  HOW  to 
of  the  following  measures :  (1)  Wring  out  croup, 
dry  in  cold  water  (60°  F.)  a  soft  cloth  folded 
into  at  least  six  thicknesses.  Place  this 
quickly  about  the  nec]^  from  ear  to  ear,  under- 
neath the  chin.  Cover  with  a  piece  of  oiled 
silk  or  thick  waxed  paper,  which  is  held  on 
by  a  handkerchief  tied  about  the  neck. 
Change  this  every  half  hour  until  the  croup 
has  subsided,  when  it  should  be  discontinued. 
(2)  Cover  the  bed  or  crib  with  a  sheet 
and  set  the  croup  kettle  going  with  the  spout 
underneath  the  sheet.  (A  steaming  tea- 
kettle kept  boiling  by  an  alcohol  lamp  or  gas 
stove  may  be  rigged  where  a  croup  kettle 
is  not  at  hand,  care  being  taken  not  to  set 
fire  to  the  bed  clothing.)  This  may  be  con- 
tinued for  hours  or  until  the  noisy  breath- 
ing has  subsided,  even  after  the  child  has 
gone  to  sleep.  (3)  If  the  breathing  is  ex- 
treme, or  if  the  above  measures  are  not 
effective,  or  if  the  croup  is  caused  by  in- 
digestion, administer  one  to  two  teaspoon- 
fuls  of  sirup  of  ipecac,  which  will  produce 


98  THE    HEALTHY    BABY 

vomiting  and  cause  the   child   to  relax   at 
once. 

Suitable  medicinal  measures  should  be 
instituted  through  the  day  to  prevent  a  re- 
currence of  the  attack  the  next  night,  and 
proper  treatment  begun  to  prevent  further 

attacks. 

CONVULSIONS 

BABIES  and  young  children  have  convul- 
to  Another!  sions  when  anything  is  wrong  just  as  the  adult 
has  a  chill  or  a  severe  headache.  The  old- 
fashioned  mother  used  to  think  that  her  baby 
was  entitled  to  so  many  convulsions  anyway, 
and  she  was  therefore  very  little  disturbed 
when  he  had  one.  This  was  very  wrong  be- 
cause even  one  convulsion,  especially  if  it  is 
prolonged,  may  do  permanent  harm.  Be- 
sides that,  one  convulsion  predisposes  to  an- 
other, and  the  more  of  them  a  baby  has  the 
more  he  is  liable  to  have.  Epilepsy  is  thus 
started  in  this  way.  Some  children  are  far 
more  liable  to  convulsions  than  others  and 
have  them  on  the  slightest  provocation. 
Unless  the  child  has  some  definite  disease 
of  the  brain,  convulsions  can  be  controlled 
by  proper  treatment  so  that  he  won't  have 


CONVULSIONS  99 

any  more,  provided  the  treatment  is  begun 
before  too  many  have  occurred. 

The  vast  majority  of  convulsions  are  caused  Various 
by  something  the  child  has  taken  into  his 
stomach,  by  indigestion,  or  by  incorrect  diet. 
By  simply  changing  the  diet,  I  have  many 
times  put  a  stop  to  convulsions  in  children 
who  have  had  them  in  increasing  numbers  for 
over  a  year.  Other  causes  are :  the  be- 
ginning of  an  acute  illness,  irritation  about 
the  genitals,  intestinal  pajasites  (worms), 
adenoids  and  enlarged  tonsils,  inflammation 
within  the  ear,  slight  injuries  to  the  head, 
teething  (exceptionally,  and  only  when  the 
process  is  abnormal),  rickets,  and  poor 
nutrition  of  any  sort.  Slight  attacks  called 
''petit  mal"  are  precursors  of  convulsions,  "Petit 
and  children  having  them  should  be  treated 
before  they  develop  into  real  ones.  In  these 
attacks  the  child  stops  suddenly  and  stares 
straight  ahead  without  moving  a  muscle. 
This  lasts  from  a  few  seconds  to  a  minute, 
and  then  he  comes  to  with  a  start  and  acts 
as  if  nothing  had  happened.  In  the  more 
severe  kind,  the  whole  body  becomes  stiff 
and  rigid  for  a  minute  and  then  it  is  over. 


100  THE   HEALTHY   BABY 

The  Treat-  When  a  child  is  suddenly  seized  with  a 
Convulsions,  convulsion,  all  is  confusion  and  we  are  un- 
prepared to  do  anything  for  him.  It  is  well, 
therefore,  to  have  some  orderly  method  of 
procedure  which  we  may  institute  at  once. 
(1)  Loosen  the  clothing,  but  do  not  take 
it  off  except  the  shoes  and  stockings.  (2) 
Place  the  child  upon  a  bed  or  table  with  his 
legs  hanging  over  the  edge  from  the  knees 
down.  (3)  Put  his  feet  and  lower  legs  into 
a  pail  of  hot  wa^er  to  which  has  been  added 
one  tablespoonful  of  powdered  mustard,  if  it 
is  at  hand.  If  there  is  no  mustard,  use  hot 
water  alone.  Be  very  careful  that  it  is 
not  hot  enough  to  burn.  (4)  Put  an  ice 
cap  to  the  head ;  lacking  an  ice  cap,  use 
plenty  of  cracked  ice  done  up  in  a  towel. 
(5)  Give  an  enema  of  warm  soapsuds. 
Repeat,  if  it  is  not  retained.  (6)  As  soon 
as  the  child  is  able  to  swallow,  give  a  large 
dose  of  castor  oil.  By  this  time  the  physi- 
cian, who  has  probably  been  hastily  sum- 
moned, will  arrive  and  he  can  give  any  medi- 
cal treatment  required  to  prevent  a  recur- 
rence of  the  convulsion. 

I  do  not  approve  of  the  full  hot  bath  in 


ACCIDENTS  101 

unskilled  hands  because  it  is  apt  to  cause  Possible 
harm  when  hastily  done.     I  have  seen  chil-  ^Fuii0' 
dren  get  bad  burns  from  such  baths,  and  I  Hot  Bath* 
have  seen  them  catch  cold  from  being  put 
into  the  bath  with  their  clothing  on  and  al- 
lowed to  lie  around  in  the  wet  clothing  after- 
ward.    It  is  usually  very  difficult  to  take  the 
clothing  off  while  the  child  is  in  the  convul- 
sion. 

Older  children  have  a  towel  or  spoon 
handle  put  between  the  teeth  so  that  the 
tongue  will  not  be  bitten.  Allow  the  child 
to  go  to  sleep  as  soon  as  possible  after  the 
attack.  After  a  child  has  had  more  than 
one  convulsion,  no  matter  how  long  the  in- 
terval between  them,  take  him  to  a  physi- 
cian so  that  the  cause  may  be  discovered, 
and  treatment  instituted  to  prevent  further 

attacks. 

ACCIDENTS 

MANY  mothers  are  not  within  reach  of  the  Emergency 
doctor  when  accidents  occur.  Consequently 
it  is  well,  especially  when  starting  out  on  a 
summer  vacation,  to  be  prepared  for  a  few 
of  the  most  common  emergencies.  The  first 
thing  is  to  lay  in  store  the  following  list  of 


102  THE    HEALTHY   BABY 

necessary  supplies :  A  five-yard  package  of 
sterile  gauze;  half  a  dozen  sterile  gauze 
bandages,  assorted  widths;  a  pound  of  ab- 
sorbent cotton;  a  bottle  of  corrosive  sub- 
limate tablets,  7 1  grains  each ;  a  bottle  of 
creolin. 

Cuts  or  In  the  case  of  cuts  or  open  wounds  of  any 
sort,  first  stop  the  hemorrhage  where  it  is 
excessive ;  second,  prevent  infection  or  blood 
poisoning  by  keeping  the  wound  clean. 
Hemorrhages  can  usually  be  stopped  by  using 
a  piece  of  sterile  gauze  held  firmly  over  the 
bleeding  spot  or  bound  tightly  over  the  cut 
with  a  bandage.  In  bad  bleeding  of  the 
extremities,  a  tourniquet  made  of  a  rope  or 
strip  of  cloth  is  twisted  tightly  about  the 
extremity  between  the  wound  and  the  body 
until  the  bleeding  has  stopped.  Where  there 
is  little  bleeding,  the  most  important  thing 
is  to  prevent  infection.  This  is  done  by 
soaking  the  wound  for  half  an  hour  in  a  hot 
antiseptic  solution  (one  corrosive  sublimate 
tablet  or  one  teaspoonful  of  creolin  to  a  quart 
of  water).  A  piece  of  sterile  gauze  wet  with 
the  antiseptic  solution  is  then  placed  upon 
the  wound,  and  after  bandaging,  is  left  un- 


ACCIDENTS  103 

disturbed  until  the  wound  has  healed;  or, 
if  gaping  open,  until  the  physician  can  give 
it  further  care. 

If  the  skin  is  unbroken,   bruises  require  Bruises. 
no  special  treatment  except,  perhaps,  where 
they  are  very  extensive,  —  in  which  event, 
ice  is  immediately  applied  and  the  injured 
part  allowed  to  rest  for  a  time. 

Fractures  or  broken  bones  are  worthy  of  Fractures 
our  notice  here  only  to  call  attention  to  the  Bones.  e' 
fact  that  often  in  infancy  and  in  childhood 
they  seem  to  cause  comparatively  little  pain. 
For  this  reason,  after  a  child  has  had  a  fall, 
he  soon  gets  over  the  original  hurt  and  makes 
no  fuss  except  perhaps  when  he  is  undressed, 
taken  up,  or  handled.  If  we  watch  him 
closely,  we  will  see  that  he  doesn't  move  the 
arm  or  the  leg  or  whatever  part  is  affected. 
I  have  had  children  brought  to  me  three  or 
four  days  after  the  accident  and  I  have  found 
that  they  had  a  broken  collar  bone  or  a 
broken  arm  which  had  gone  unnoticed  for 
that  length  of  time. 

Nosebleeds,  if  habitual,  are  caused  usually  Nosebleeds. 
either  by  adenoids  or  by  ulcerations  on  the 
inside  of  the  nose.     Both  of  these  conditions 


104  THE    HEALTHY   BABY 

should  receive  their  appropriate  treatment 
in  order  to  stop  them  permanently.  The 
treatment  at  the  time  of  the  nosebleed  con- 
sists in  keeping  the  child  quiet  in  the  up- 
right position,  unless  he  is  faint,  putting  a 
piece  of  ice  to  the  back  of  the  neck,  and  hold- 
ing the  nose  firmly  between  the  thumb  and 
forefinger.  The  latter  is  done  on  the  chance 
that  the  bleeding  is  caused  by  an  ulceration 
on  the  septum  of  the  nose.  Blowing  the  nose 
is  prohibited  until  all  chance  of  a  return  of 
the  hemorrhage  has  gones 

Foreign  Foreign  bodies,  such  as  beans  or  pebbles, 
the  Ear  or  in  the  ear  or  nose  should  not  be  too  vigor- 
Nose.  ousiy  sOUght  for  by  the  untrained  attendant, 
as  sometimes  this  serves  only  to  poke  them 
farther  in  or  to  break  them  into  bits  so  that 
the  physician  has  a  good  deal  of  difficulty  in 
removing  them  when  it  comes  his  turn  to 
try  and  get  them  out.  We  should  also  re- 
member that  there  is  no  urgent  hurry  about 
removing  them  as  they  may  remain  there  a 
number  of  hours  without  causing  serious 
harm.  However,  if  there  is  no  physician 
available,  a  small  steel  hairpin  may  be 
straightened  out  and  a  small  hook  made  of  it 


ACCIDENTS  105 

by  bending  one  end  over  sharply  (|  inch). 
This  is  then  passed  up  the  nose  flat  against 
the  septum  or  inner  wall  and  after  the  hook 
has  passed  by  the  foreign  body,  it  is  turned 
outward,  so  that  it  will  catch  upon  the  top 
of  the  offending  particle,  and  pulled  gently 
down.  The  same  process  may  be  used  in  the 
ear,  but  it  is  more  difficult,  and  I  would  not 
advise  it  except  in  case  of  absolute  necessity. 

Foreign  bodies  in  the  throat,  too,  are  often  Foreign 
not  so  urgent  as  they  at  first  seem.  As  long  th°e  Throat, 
as  the  child  is  breathing  all  right  and  is  not 
blue  in  the  face,  do  not  do  anything  to  make 
matters  worse.  It  is  marvelous  the  size  of 
object  a  child  can  get  into  his  throat  without 
a  great  deal  of  discomfort.  I  recall  the  case 
of  a  child  six  months  old  who  had  swallowed 
a  silver  dollar.  His  mother  was  sure  he  had 
swallowed  it  because  she  had  seen  it  go  into 
his  mouth,  and  had  poked  at  it  with  a  pair 
of  scissors  as  it  was  going  down.  When  I 
got  there,  the  child  was  in  far  better  condition 
than  the  mother,  and  breathing  more  regu- 
larly. I  put  in  my  finger  and  pulled  out  a 
plum,  in  the  form  of  a  silver  dollar,  that  had 
lodged  behind  the  palate  —  where  she  had 


106  THE    HEALTHY    BABY 

poked  it,  I  presume.  In  case  the  breathing 
is  hard  and  the  child  is  choking,  grab  him  by 
the  legs  and  hold  him  upside  down  while 
some  one  pounds  him  on  the  back.  If  he 
does  not  cough  the  object  up  and  is  still  blue 
in  the  face,  put  your  finger  as  far  back-  in 
the  throat  as  you  can  reach  and  try  to  dis- 
lodge it. 

when  Children  often  swallow  such  things  as 
Bwailow  open  safety  pins,  screws,  and  coins  without 
Things."  jtg  doing  them  any  harm.  In  due  time 
these  objects  travel  through  the  stomach 
and  bowels  into  the  world  again.  *  Do  not 
administer  cathartics,  but  give  the  child 
plenty  of  coarse  food  —  oatmeal,  potatoes, 
and  bran  biscuits.  In  these  days  of  the  X-ray 
machine,  it  is  best  to  take  the  child  to  your 
doctor,  who  will  locate  the  foreign  body  and 
make  sure  it  is  not  in  a  place  where  it  will 
do  harm. 

Foreign  bodies  in  the  eye,  if  they  have  not 
penetrated  any  part  of  the  eyeball,  are  best 
removed  by  pulling  the  lid  away  from  the  eye- 
ball with  the  finger  so  that  the  tears  will 
flow  and  wash  the  particle  away.  Never  rub 
the  eye.  When  the  eye  ball  is  penetrated, 


ACCIDENTS  107 

you  cannot  take  the  child  to  an  oculist  too 
quickly. 

There  are  three  degrees  of  burns.  The  Burns, 
first  is  simply  a  reddening  or  inflamed  condi- 
tion of  the  skin  ;  the  second  destroys  the 
first  layer  of  the  skin,  causing  blisters ;  and 
the  third  injures  the  flesh  itself.  For  the 
reddening  or  simple  inflammation  all  that  is 
necessary  is  to  relieve  the  pain,  and  this  may 
be  done  by  covering  the  burned  part  with 
sweet  oil  and  lime  water,  equal  parts  of  each. 
If  this  is  not  at  hand,  sweet  oil  alone,  or 
even  lard  or  vaseline  may  be  used.  A  burn 
of  the  second  degree  should  be  treated  just 
like  an  open  wound,  because  when  the  blister 
breaks,  infection,  or  blood  poisoning,  may  set 
in  if  it  is  not  kept  perfectly  clean.  For  this 
reason,  it  should  be  entirely  covered  with  a 
piece  of  gauze  soaked  in  a  weak  antiseptic 
solution,  such  as  I  have  described  in  "Open 
Wounds."  It  should  then  be  left  alone  un- 
til seen  by  a  physician.  Burns  of  the  third 
degree,  where  the  flesh  is  actually  destroyed, 
should  be  treated  in  the  same  way.  These 
are  apt  to  be  much  more  serious  and  will  in 
all  probability  leave  a  scar. 


108  THE    HEALTHY   BABY 

Poisons.  Children  more  often  take  poisons  of  vari- 
ous kinds  than  do  adults.  As  prevention  is 
better  than  a  cure,  all  poisonous  substances 
and  medicines  should  be  kept  out  of  the  reach 
of  the  child,  and  not  be  left  where  he  may 
get  them.  Disregarding  this  rule  has  caused 
many  a  mother  regret  to  the  end  of  her  life. 
Most  medicines,  if  taken  in  excessive  quanti- 
ties, are  poisonous.  We  should  always  bear 
this  in  mind. 

As  soon  as  it  is  discovered  that  the  child 
has  taken  poison,  send  for  the  doctor  at  once, 
telling  him,  if  possible,  what  poison  has  been 
taken  so  that  he  may  come  prepared  for  the 
emergency.  It  is  always  well  to  remember 
that  an  antidote  for  the  poison  is  often  printed 
upon  the  bottle  in  which  the  poison  came. 
This  saves  time  in  looking  up  the  treatment. 
A  general  principle  which  it  is  safe  to  follow 
is  to  make  the  child  vomit  at  once.  What- 
ever the  poison,  the  sooner  it  comes  up  the 
less  harm  it  will  do.  If  the  antidote  is  known, 
it  may  be  given  before  the  emetic  which  is 
to  produce  the  vomiting,  and  in  some  in- 
stances repeated  after  the  vomiting.  The 
best  emetics  are  those  which  are  always  at 


BED-WETTING  109 

hand  in  every  household.  Mustard  flour, 
two  teaspoonsful  to  a  glass  of  water,  usually 
starts  vomiting  at  once.  As  soon  as  it  is 
swallowed,  the  finger  is  stuck  down  the  throat 
to  cause  gagging,  so  that  the  child  will  not 
retain  the  mustard  long  enough  to  burn  the 
stomach.  Another  good  way  to  produce 
vomiting  is  to  give  a  glassful  of  strong  soap- 
suds. Sometimes  just  sticking  the  finger 
into  the  throat  after  giving  a  glass  of  warm 
water  will  produce  the  desired  result.  Sirup 
or  wine  of  ipecac,  one  to  two  teaspoonsful, 
is  the  best  emetic  of  all,  but  it  is  not  always 
at  hand.  A  list  of  antidotes  for  the  various 
poisons  is  appended  in  the  back  of  this 

book. 

BED-WETTING 

THERE  are  many  causes   of  bed-wetting,  Causes  of 
and  it  is  always  well,  first,  to  find  the  cause  Wgtting. 
before  trying  to  treat  the  child  for  this  con- 
dition.    A  small  percentage  of  the  children 
who  have  this  unfortunate  failing  have  some 
organic    error    back    of    it.     The    principal 
disturbances  of    this  sort  are  adenoids,  en- 
larged tonsils,  and  irritation  about  the  geni- 
tals, incorrect    diet,  constipation,  and    pin- 


110  THE    HEALTHY   BABY 

worms.  Although  it  is  necessary  to  make 
sure  that  the  bed-wetting  child  has  none  of 
these  things,  such  cases  are  far  in  the  minor- 
ity. The  vast  majority  are  caused  by  lack 
of  training  in  early  years.  When  the  child 
is  eight  or  nine  months  of  age,  he  should  be 
trained  to  use  the  vessel  instead  of  remaining 
wet.  In  this  way  he  learns  to  make  the  act 
a  voluntary  one  under  the  control  of  his  will. 
It  is  a  lot  of  work  to  put  the  child  on  the  vessel 
every  hour  throughout  the  day,  but  in  the 
end  it  saves  a  lot  of  trouble.  It  is  surprising 
how  soon  children  with  the  help  of  this  train- 
ing will  learn  to  use  the  chair.  At  the  end 
of  the  first  year  he  will  reward  his  mother  by 
remaining  dry  all  the  time.  At  eighteen 
months  of  age,  the  ten  o'clock  nursing  is 
usually  stopped.  This  gives  the  baby  a 
chance  to  remain  dry  during  the  night.  If 
he  is  taken  up  when  the  mother  goes  to  bed, 
and  possibly  once  more  during  the  night  for 
the  first  few  weeks,  he  soon  learns  to  keep 
dry  all  night  long.  By  two  years  of  age,  he 
should  stop  wetting  the  bed  altogether. 
The  Cure  How  about  the  older  child  who  has  already 
wetting!  established  the  habit  of  bed- wetting?  We 


BED-WETTING  111 

should  first  make  sure  that  he  has  none  of 
the  organic  troubles  of  which  I  have  spoken. 
Probably  it  will  be  necessary  to  have  him 
examined  by  a  physician  in  order  to  be  as- 
sured that  everything  is  all  right.  This  at- 
tended to,  we  should  proceed  in  the  follow- 
ing manner :  (1)  Begin  with  him  just  as 
though  he  were  a  little  baby  and  put  him 
on  the  chair  once  an  hour  throughout  the 
day  in  order  to  get  the  bladder  functions  un- 
der the  control  of  the  will.  This  is  kept  up 
for  about  two  weeks,  and  then  we  may 
lengthen  the  intervals  to  an  hour  and  one 
half  for  two  weeks  more.  After  that,  the 
intervals  are  increased  gradually  until  he  is 
made  to  pass  his  urine  once  in  three  hours 
throughout  the  day.  This  is  a  matter  of 
training  and  should  be  rigidly  followed  for 
the  effect  that  it  has  at  night.  Regardless 
of  the  fact  that  the  child  may  already  have 
good  control  in  the  daytime,  it  teaches  him 
to  pass  his  urine  at  will.  (2)  At  first  he 
should  be  taken  up  three  times  each  night, 
later  twice,  then  once,  and  finally  not  at  all 
after  ten  o'clock.  It  is  usually  advisable  to 
take  every  child  up  at  nine  or  ten  o'clock  at 


112  THE   HEALTHY   BABY 

importance  night,  until  five  or  six  years  of  age.    (3)  No  liq- 
i°n  Bed-  uids  should  be  allowed  after  4  P.M.     The  sup- 


wetting.  per  should  be  absolutely  dry,  since  soups  and 
milk  and  such  things  are  just  as  bad  as  water. 
This  is  a  great  hardship,  but  it  is  absolutely 
necessary.  (4)  The  supper  should  be  a  light 
one,  consisting  of  bread,  toast  or  crackers, 
with  apple  sauce  or  cut  fruit,  or  the  little 
child  occasionally  may  have  cereal  with 
butter,  to  break  up  the  monotony  of  the  diet. 
The  diet  throughout  the  day  should  be,  of 
course,  a  sensible  one.  (5)  No  tea  nor  coffee 
is  allowed.  They  are  stimulants  that  no 
child  should  have,  but  are  especially  harmful 
for  bed-wetting  children.  (6)  Finally,  if 
this  treatment  is  not  successful  in  breaking 
up  the  habit,  medicinal  measures  are 
necessary,  and  the  physician  should  be  con- 
sulted. 
DO  not  A  child  should  never  be  punished  for  bed- 

Punish  Bed-  ...  ,  _.  i  M  i  TTI        ,1        11-, 

wetting  wetting.  Most  children  dislike  the  habit  as 
ren-  much  as  the  parents  do,  and  it  is  punishment 
enough  for  them  to  wake  up  wet  each  morn- 
ing. The  younger  the  child,  the  more  easy 
it  is  to  overcome  this  habit  of  bed-wetting, 
and  if  such  treatment  is  started  soon  after 


WORMS  113 

the  second  year,  the  habit  can  usually  be 
controlled  very  easily  in  a  few  weeks.  After 
five  years  of  age,  it  may  take  months  to  effect 
a  cure.  Children  who  suddenly  acquire  the 
habit  of  bed-wetting  in  later  childhood  al- 
ways have  some  organic  cause  which  should 
be  attended  to  at  once.  Usually  this  is 
some  disease  of  the  urinary  tract. 

Wetting  the  clothes  in  the  daytime  is  a 
still  more  uncomfortable  habit,  and  it,  too,  is 
most  often  caused  by  lack  of  proper  training. 
The  same  treatment  should  be  used  for  this 

condition. 

WORMS 

THERE  was  a  time  when  every  mother  Symptoms 
thought  that  her  child  had  worms  whenever 
he  was  not  in  his  usual  good  health,  and  the 
doctor  laughed  at  the  idea.  Now  we  know 
that  many  children  do  have  worms,  especially 
country  children  and  those  who  drink  well 
water  in  the  summer.  Of  course,  a  great 
many  children  who  have  all  the  symptoms  of 
worms  (grit  their  teeth  at  night,  have  a 
foul  breath,  and  an  irritation  about  the  nose 
which  causes  them  to  pick  at  it,  or  even  have 
convulsions),  simply  have  indigestion.  Any 


114  THE    HEALTHY   BABY 

irritation  about  the  rectum,  if  unexplained 
otherwise,  is  especially  significant  of  pin- 
worms.  The  general  health  of  children  with 
worms  may  or  may  not  be  poor.  Often,  how- 
ever, they  are  pale  and  listless  or  nervous 
and  irritable.  The  appetite  may  be  poor,  and 
it  is  rarely  as  ravenous  as  some  parents  ex- 
pect it  to  be.  It  is  not  a  bad  practice  to 
How  to  Tell  watch  the  stools  of  these  children.  The  onlv 

whether  or  J 

not  a  way  we  can  make  sure  whether  or  not  the 
cnild  has  worms  is  to  see  them  in  the  stools 
or  have  the  stools  examined  for  the  eggs. 
There  are  three  common  varieties :  pin- 
worms,  which  look  like  short  bits  of  white 
thread;  roundworms,  which  are  two  to  six 
inches  long  and  look  like  earthworms;  and 
tapeworms,  the  latter  come  away  in  flat 
segments  like  a  piece  of  ordinary  tape. 

Once  it  is  determined  a  child  has  worms  of 
any  sort,  it  is  useless  to  dally  with  a  little  worm 
medicine;  instead,  a  regular  course  of  treat- 
ment must  be  instituted,  lasting  over  a  num- 
ber of  days  or  even  weeks.  This  involves 
diet,  as  well  as  medicine,  and  is  too  compli- 
cated for  a  work  of  this  sort. 


THE   NERVOUS   CHILD  115 

THE  NERVOUS  CHILD 

THERE  is  no  doubt  that  some  children  are 
much  more  nervous  than  others.  They 
either  come  from  nervous  families  and  natu- 
rally have  a  nervous  disposition,  or  are  made 
nervous  by  their  surroundings  and  treatment. 
Such  children  must,  of  course,  have  different 
treatment  from  the  placid  easy-going  child 
who  is  never  upset  by  anything.  And  what  Different 
do  we  mean  by  a  nervous  child?  In  the  showing 
first  place,  one  who  is  easily  upset  by  a  slight  Nervous- 
cause,  or  one  who  is  easily  frightened,  or  per- 
haps a  child  who  cries  a  great  deal  on  slight 
provocation.  Some  children  show  their  nerv- 
ousness by  being  afraid  of  things  that  ought 
not  to  cause  fear,  and  others  show  their 
nervousness  by  having  various  pains  and 
imaginary  ills,  just  as  the  hypochondriac 
adult  does.  The  twitching  of  a  group  of 


muscles  is  another  way  that  the  child  has  of  ' 

showing  his  nervous  make-up.  These  mo- 
tions are  called  habit  spasms  or  tics.  They 
are  so  common  that  they  hardly  need  de- 
scription. The  child  who  continually  blinks 
his  eyes  or  shrugs  his  shoulders  or  makes  anj 


116  THE   HEALTHY   BABY 

peculiar  motion  of  the  body  does  it  more  and 
more  often  until  it  has  become  such  a  fixed 
habit  that  he  can  only  overcome  it  with  great 
difficulty.  Some  children  even  have  a  nerv- 
ous cough  or  rasping  of  the  throat  which 
becomes  more  and  more  a  habit.  It  is  very 
important  to  overcome  these  things  in  their 
beginning  because  if  this  is  not  done,  the 
child  grows  up  to  be  a  nervous  adult  and  has 
hysteria  and  various  other  neurotic  tenden- 
cies all  his  life. 

The  unfortunate  part  of  the  whole  subject 
is  that  the  nervous  child  usually  comes  by  his 
affection  honestly;  that  is,  he  inherits  a  nerv- 
ous disposition  from  one  or  both  of  his  parents, 
and  at  the  same  time  being  constantly  associ- 
The  ated  with  them,  he  is  surrounded  by  nervous 
^Nervous  influences.     For   that   reason   I   have  occa- 
Surround-  sjonaiiy  found  it  necessary  in  some  of  the 
worst  cases,  to  separate  the  child  from  the 
nervous  mother.     This  may  be  done  by  send- 
ing the  child  away  to  stay  with  some  relative, 
always  being  careful  to  select  one  who  is  not 
nervous  herself.     In  other  cases,  a  nurse  may 
be  found  who  is  not  of  a  nervous  or  excitable 
disposition.     This  will  answer  the  purpose 


THE    NERVOUS    CHILD  117 

very  well  if  she  is  allowed  to  have  full  con- 
trol of  the  child.  In  still  other  cases,  a 
mother,  once  she  understands  the  cause  of 
the  child's  condition,  can  be  brought  to  look 
upon  it  in  a  sensible  manner,  and  overcome 
it  herself. 

It  is  impossible  to  give  any  one  plan  of  Treatment 
treatment  for  all  nervous  children,  because  children!18 
each  case  is  different,  and  each  child  must  be 
handled  with  the  utmost  common  sense  and 
tact.  There  is  one  rule  which  applies  to  all, 
and  that  is  for  those  who  surround  the  child 
never  to  become  excited  themselves.  Some 
children  can  be  broken  of  their  nervousness 
by  severe  and  strict  discipline,  while  others 
must  be  humored  to  a  certain  extent.  They 
should  never  be  allowed  to  listen  to  a  recital 
of  their  own  nervous  symptoms,  and  they 
should  not  continually  be  told  that  they  are 
nervous.  In  fact,  it  is  sometimes  best  to 
overlook  the  nervous  symptoms  altogether. 
They  should  be  allowed  to  play  with  other 
children  of  their  own  age,  and  not  kept  by 
themselves,  as  is  often  done.  Sometimes 
in  the  younger  children  the  nervous  symptoms 
disappear  when  the  child  starts  to  school. 


118  THE    HEALTHY   BABY 

In  the  older  children  of  the  school  age,  the 
nervousness  may  be  aggravated  by  hard 
study  or  indoor  life.  Occasionally,  a  com- 
plete change  of  surroundings  is  beneficial. 
This  change  of  surroundings  is  far  more 
effective  with  children  than  with  adults, 
because  children  forget  more  easily.  Their 
curiosity  stimulates  them  to  new  things  more 
quickly,  and  old  ties  are  soon  cut  off. 

Many  nervous  children  do  not  get  enough 
sleep.  Sometimes  they  sleep  poorly  because 
of  the  nervousness  and  sometimes  it  is  be- 
cause their  daily  routine  is  not  a  proper  one. 
At  the  same  time,  the  lack  of  sleep  makes 
them  still  more  nervous.  The  diet,  also,  has 
a  great  deal  to  do  with  causing  such  a  con- 
dition. The  strictest  diet  must  be  estab- 
lished and  maintained.  The  child  who  has 
more  or  less  indigestion,  or  who  does  not 
take  plenty  of  good  nourishing  food,  could 
only  be  expected  to  be  nervous. 


PART  IV 
CARE  OF  THE   SPECIAL  ORGANS 


THE  THROAT 

THE  throat,  unlike  the  eyes,  ears,  and  teeth,  The  Value 
is  an  organ  that  needs  no  special  local  treat-  ExIiSn^ 
ment  in  health.  In  fact,  the  use  of  sprays  tion- 
and  applications  in  the  healthy  nose  and 
throat  is  to  be  deprecated.  The  healthy 
throat  depends  upon  the  general  condition 
of  the  child  and  his  mode  of  life.  It  is  a  good 
practice,  however,  to  accustom  the  child  to 
a  throat  examination  after  he  is  old  enough 
to  understand  that  it  will  do  him  no  harm. 
When  he  is  ill,  he  then  submits  to  the  examina- 
tion without  being  upset  by  it,  which  some- 
times makes  a  great  deal  of  difference  in  the 
outcome  of  the  illness.  It  is  also  well  for 
the  mother  to  become  familiar  with  the  ap- 
pearance of  the  normal  throat,  so  that  she 
may  recognize  early  any  acute  affection  there. 

Adenoids  and  enlarged  tonsils  are  the  two  Adenoids 
chief  chronic  conditions  of  the  throat  that  are  fagged0" 
common  in  children.     Adenoids  consist  of  a  Tonsils- 
grapelike  mass  of  tissue  which  grows  back 
of  the  palate  in  the  passage  that  leads  from  the 
throat  to   the   nose  through  which   the  air 
must  pass  when  the  mouth  is  shut.     They 

121 


122  THE   HEALTHY   BABY 

may  be  large  and  completely  fill  the  passage, 
or  they  may  be  smaller  so  that  some  air  may 
pass  by  them.  Tonsils  are  normally  in  the 
throat.  They  are  harmful  when  they  are 
much  enlarged  or  ragged,  or  are  the  cause 
of  frequent  illnesses. 

Cause  of       We  often  hear  the  question  asked,  "Why  do 

Aden^  so  many  children  have  adenoids  and  tonsils 
Tonsils.  nowadays?  They  used  to  be  unheard  of." 
There  are  two  answers  to  this  question.  The 
first  is  that  we  live  under  different  conditions 
than  we  formerly  did.  Apartment-house  life, 
steam-heated  houses,  richer  foods,  more  cod- 
dling, and  the  constant  use  of  nipples  or  baby 
comforts,  have  brought  about  this  condition. 
The  second  reason  is  that  children  did  have 
them,  but  they  were  unrecognized  at  that 
time. 
Why  Many  an  adult  carries  about  with 

aiKTEn-  him    to-day    physical    abnormalities    which 
Tonsils  are   the   result   of   untreated   adenoids   and 

should  be  tonsils.     Deafness  for  life  is  one  of  them.     A 

removed. 

deformed  narrow  jaw  and  prominent  nose 
with  the  characteristic  open  fish  mouth  is 
another.  How  many  people  do  we  see  in 
the  course  of  a  year  who  have  grown  up  with 


THE   THROAT  123 

this  typical  facial  expression,  when  they 
might  have  been  beautiful  to  look  upon  if 
their  throats  had  been  properly  attended  to 
in  childhood?  Upon  the  question  of  tonsils 
the  writer  feels  very  strongly,  for  through 
his  childhood  he  had  three  or  four  attacks 
of  tonsillitis  a  year  which  still  leave  a  lasting 
impression  upon  his  mind  and  which  would 
have  been  eliminated  had  his  throat  received 
proper  treatment.  The  tonsils  are  also  the 
seat  of  entrance  of  many  other  infections 
besides  tonsillitis. 

Breathing  with  the  mouth  open  night  cr  Symp- 
day,  snoring  at  night,  restless  sleeping,  poor  Adenoids, 
nutrition    and    debility,    loss    of    appetite, 
nervousness,  bed-wetting,  impaired  hearing, 
as  shown  by  lack  of  attention,  backwardness 
in     school,     seeming    stupidity,     nosebleed, 
defective  speech,  a  nasal  voice,  and  frequent 
colds,  —  all  are  symptoms  of  adenoids. 

The  only  treatment  that  is  of  any  avail  is  Removal 
to  remove  them.     It  is  sometimes  wonderful  Effective 
the  immediate   improvement   following  this  Treatment 
procedure.     As  to  the  age  at  which  this  may 
be   done,    I   would   most   emphatically   say 
that   there   is   no   age   limit.     I   have   seen 


124  THE   HEALTHY   BABY 

babies  four  months  old  who  have  never 
done  well  because  of  the  obstructed  breath- 
ing during  nursing  and  sleep.  The  removal 
of  the  adenoids  caused  them  to  show  im- 
provement at  once,  so  that  they  took  the 
first  good  nursing  of  their  lives  a  half  hour 
later,  and  got  fat  and  strong  without  delay. 
Do  .Another  question  that  is  frequently  asked 
is,  "Do  adenoids  return?"  They  some- 
times do  grow  again,  but  that  is  no  argu- 
ment against  their  removal.  A  child  is 
developing  every  day  of  his  life,  and  if  the 
operation  gives  him  only  a  year,  in  which  he 
is  free  of  this  obstacle  to  his  proper  develop- 
ment, just  so  much  is  gained.  They  may  be 
removed  again  if  necessary,  but  fortunately 
this  is  not  a  common  occurrence. 

THE  TEETH 

THE  first  tooth  is  awaited  with  the  greatest 
interest,  and  let  us  hope  that  this  interest 
in  those  useful  and  beautifying  organs  of 
mastication  will  not  abate  as  the  novelty 

When  the  ceases  *°  De  entertaining. 

Teeth       The  two  lower    central  teeth    come  first, 

should 

Appear,  at  six  or  eight  months ;  the  four  upper  central 


THE   TEETH  125 

teeth  two  months  later ;  within  the  next  two 
months  the  two  other  lower  teeth  appear  on 
either  side  of  their  fellows.  Taking  count, 
therefore,  we  have  the  eight  central  teeth 
at  a  year  or  a  little  later.  At  fourteen  to 
sixteen  months  come  the  four  double  teeth, 
and  at  a  year  and  a  half  the  eye  and 
stomach  teeth  come  along  to  fill  in  the 
space  that  intervenes.  There  are  then  six- 
teen teeth,  the  full  complement  with  which 
the  child  may  chew  hard  food.  We  may 
not  expect  the  four  other  double  teeth  until 
two  and  one  half  years,  when  our  baby  has  all 
the  temporary  masticators,  twenty  in  number  % 

We  should  not  worry  too  much  if  the  teeth  Delay  or 
do    not    come    along    upon    schedule    time.  it^hT* 
The  breast-fed  child  is  far  more  apt  to  have  Teethin«- 
his  teeth  early  and  easily,  than  is  the  bottle- 
fed  baby,  and  the  children  of  certain  families 
are  prone  to  early  teething,  while  others  get 
theirs    late.     Any    marked    delay    or    great 
irregularity  of  teething  may  be  caused  by 
errors  in  diet  or  by  nutritional  abnormalities. 
Extreme  delay  in  teething  should  be  looked 
into,  as  rickets  and  other  nutritional  diseases 
are  particularly  apt  to  cause  it. 


126  THE    HEALTHY   BABY 

Teething  a  Teething  during  the  summer  is  often 
Process,  dreaded  by  the  mother,  but  if  her  child  is 
Dreaded6  Pr°Perly  nourished  and  well  cared  for,  she 
need  not  fear  any  great  amount  of  disturb- 
ance. We  are  apt  to  lay  everything  to 
teething  because  it  is  easier  to  explain  an 
illness  in  that  way  than  it  is  to  look  into  the 
real  cause.  We  must  remember  that  teething 
is  a  natural  process,  as  normal  as  the  develop- 
ment of  the  bones  or  muscles  or  any  other 
part  of  the  body ;  it  is  so  easy  to  say  a  child 
has  this  or  that  "because  he  is  teething." 
I  have  had  the  privilege  of  observing  a  great 
.many  children  during  the  teething  period 
and  it  is  in  the  great  minority  of  my  cases 
that  I  see  much  disturbance  from  this  cause. 
This  is  not  invariably  true,  however.  Per- 
haps a  few  days'  discomfort  is  experienced 
and  the  tooth  comes  through.  However, 
when  the  gums  are  red  and  swollen  and  the 
child  is  irritable  or  even  sick  from  the  dis- 
comfort, we  should  help  the  eruption  of  the 
tooth  by  rubbing  the  inflamed  gums  with  a 
rough  towel.  Such  a  procedure  is  usually 
welcomed  by  the  uncomfortable  baby  and 
may  bring  a  tooth  through  far  sooner  than 


THE   TEETH  127 

it  would  otherwise  have  come.  Lancing 
of  the  gums  is  occasionally  necessary,  but 
when  it  is  done  too  early,  a  scar  is  left  which 
is  far  harder  for  the  tooth  to  penetrate 
than  it  would  have  been  if  we  had  not 
meddled. 

The  eruption  of  the  second  teeth  gives  very  The 
little   discomfort,    which   is   sufficient   proof 


in  my  opinion  of  the  theory  that  the  first  Je  Second 

1  t*oto. 

teeth  should  come  through  without  much 
trouble.  The  molars  or  back  teeth  are  the 
first  to  appear  at  five  or  six  years  of  age, 
before  any  of  the  first  or  temporary  teeth 
have  come  out.  At  seven  years  comes  the 
ugly  stage  when  the  front  teeth  drop  out, 
but  the  space  is  soon  filled  by  the  permanent 
teeth.  At  nine  to  ten  years  the  temporary 
double  teeth  give  place  to  the  permanent 
double  teeth,  the  bicuspids.  At  twelve  years 
the  canines,  or  pointed  teeth,  take  the  place 
of  the  temporary  ones,  and  at  twelve  to 
fourteen  years  the  next  double  teeth,  or 
second  molars,  appear  behind  those  that 
came  at  six  years.  Finally,  when  the  child  is 
a  child  no  longer,  —  at  eighteen  to  twenty- 
five  years  of  age,  —  the  wisdom  teeth  come 


128  THE    HEALTHY   BABY 

along  to  make  up  the  full  set  of  thirty-two 
teeth. 

The  Care  The  care  of  the  teeth  begins  as  soon  as 
Teeth6  the  first  one  comes  through.  The  softest 
toothbrush  it  is  possible  to  get,  baby  size, 
is  purchased,  and  the  teeth  brushed  night 
and  morning.  Later  the  brushing  is  best 
done  after  each  meal.  Tooth  powder  should 
not  be  used,  but  a  mild  antiseptic  like  glyco- 
thymoline  is  added  to  the  water.  The  teeth 
are  brushed  up  and  down,  as  well  as  from  side 
to  side.  Pay  as  much  attention  tu>  brushing 
the  child's  gums  as  you  do  the  teeth,  as  it 
keeps  them  in  good  condition.  It  is  not 
necessary  to  pass  a  thread  between  the  teeth 
if  their  contour  is  good,  because  nature 
has  made  their  shape  so  perfect  as  to  allow  no 
food  to  collect  there.  But  if  they  are 
irregular  or  have  once  started  to  decay,  it  is 
of  the  greatest  necessity  to  use  the  thread 
after  each  meal. 

Causes  of  The  causes  of  decayed  teeth  are  three  in 
Teeth,  number :  errors  in  diet,  lack  of  proper  clean- 
ing, and  disuse,  by  which  I  mean  the  absence 
of  hard  chewable  food  in  the  diet.  The  diet 
should  be  nourishing  and  contain  the  proper 


THE   TEETH  129 

proportions  of  meat,  eggs,  vegetables,  fruits, 
starches,  and  fats.  There  should  be  no  eat- 
ing between  meals  and  a  minimum  amount 
of  sweets  should  be  taken.  Cereals  and  soft, 
mushy  food  should  not  be  given  to  the  exclu- 
sion of  hard  food.  Bread  toasted  in  the  oven, 
zwieback,  hard  crackers,  are  an  important 
part  of  the  dietary,  and  they  should  be  chewed 
without  moistening  so  the  child  can  harden 
his  teeth  by  long  chewing.  Dogs  naturally 
have  exceptionally  hard  teeth  because  long 
use  in  chewing  up  bones  has  made  them  so. 
Nature  usually  arises  to  the  demands  put 
upon  it,  and  I  believe  the  present  generation 
has  bad  teeth  as  much  from  this  lack  of  use  as 
from  any  other  cause.  This  is  not  a  theory, 
but  a  fact  that  I  have  put  into  practice 
with  remarkable  results. 

When  there  is  a  decayed  spot,  it  should  be  The 
filled  at  once.  The  teeth  should  thereafter 
be  inspected  once  or  twice  a  year  by  a 
dentist.  The  temporary  teeth  should  not 
be  extracted  before  their  time  unless  it  is 
absolutely  impossible  to  fill  them.  Remem- 
ber that  the  six-year-old  molars  are  perma- 
nent teeth  and  take  special  care  of  them. 


130  THE   HEALTHY   BABY 

Brittle  teeth  are  sometimes  caused  by  ade- 
noids. Protruding  teeth  are  most  often 
caused  by  finger  sucking.  Irregularity  of  the 
second  teeth  should  be  attended  to  by  the 

dentist. 

THE  EYES 

Care  of  THE  first  care  of  the  eyes  rests  with  the 
during  the  physician,  who  puts  antiseptics  into  them  to 
First  Year.  prevent  any  infection  that  they  may  get 
during  the  baby's  introduction  into  the 
world.  After  that,  the  nurse  washes  them 
out  each  morning  with  a  clean  piece  of  cotton 
soaked  in  a  fresh  solution  of  boracic  acid, 
one  level  teaspoonful  to  a  cup  of  boiled  water. 
This  is  kept  up  during  the  first  year.  Any 
discharge  from  the  eyes  should  not  be 
tampered  with  by  the  mother  or  nurse.  The 
physician's  attention  should  be  called  to  the 
condition  at  once.  The  vast  majority  of 
blind  people  owe  their  misfortune  to  neglect 
at  this  time. 

Danger       Baby,  like  the  moth,  seems  to  be  fascinated 

strong  by  a  strong  light,  so  he  should  not  be  laid 

Llght-  where  he  can  stare  at  one  when  he  is  small, 

nor  should  the  sun  be  allowed  to  shine  directly 

into  the  unprotected  eyes.     I  am  not  sure 


THE   EYES  131 

but  that  this  is  one  factor  in  the  causation 
of  weak  eyesight  in  the  children  of  the  present 
generation. 

The  next  period  at  which  the  eyes  are  Eye 
called  to  our  attention  is  at  the  time  the 
child  starts  to  school.     I  think  it  would  be 

at  School 

a  splendid  practice  if  every  child  had  a  Age. 
thorough  eye  examination  by  a  competent 
oculist  before  he  began  his  school  life.  Any 
defects  of  sight  would  then  be  discovered 
and  proper  treatment  instituted  at  once. 
Many  children  appear  stupid  in  school  be- 
cause they  cannot  see  the  blackboard,  their 
eyesight  being  deficient.  Headaches  are  fre- 
quently caused  by  defective  vision. 

I  am  sorry  to  say  that  not  enough  attention 
is  paid  to  the  proper  lighting  of  schoolrooms. 
The  light  should  come  in  through  the  windows 
behind  the  children  so  that  it  shines  over 
their  shoulders  on  to  the  desk  instead  of 
striking  them  directly  in  the  eyes. 

The  child  who  is  cross-eyed  or  has  any  Defective 
noticeable  defect  should  consult  the  oculist     yea 
early,    for    during    early    childhood    glasses 
may  remedy  a  defect  which  will  require  an 
operation  later  on. 


THE    HEALTHY    BABY 


THE  EARS 

Washing  THE  ears  should  be  washed  daily  with 
boric  acid  and  water.  The  best  thing  for 
this  purpose  is  a  small  piece  of  cotton  wound 
about  a  toothpick.  One  should  never  try 
to  wash  far  into  the  ear,  or  put  any  small 
object  like  a  hairpin  into  it  to  take  out  the 
wax  or  for  any  other  purpose.  The  ears 
should  not  be  bundled  too  much  and  the  thick- 
ness of  the  bonnet,  if  worn,  should  not  change 
from  day  to  day.  (See  "Clothing. ") 
TO  Prevent  Protruding  ears,  or  ears  which  are  doubled 
'  "8  over  from  lying  upon  them,  should  be  attended 
to  in  infancy  if  we  care  anything  about  the 
child's  appearance  in  later  life.  When  the 
child  is  too  young  to  turn  over  of  his  own 
accord,  we  should  see  that  the  ear  is  flat  when 
he  is  laid  down.  Later,  when  he  becomes 
more  active,  prominent  ears  should  be  kept 
back  tight  to  the  head  by  a  skeleton  bonnet 
made  of  tape  which  comes  over  the  ears  and 
ties  under  the  chin.  These  may  be  bought 
at  any  children's  furnishing  store. 

Defective  hearing  is  first  shown  by  the 
child's   becoming  inattentive.     I   recall   the 


THE    EARS  133 

case  of  a  child  three  and  one  half  years  old  Causes  and 
who  had  been  irritable  and  unlike  himself  for  effective 
three  weeks,  although  he  had  seemed  other-  Heanng- 
wise  in  good  health.     His  mother    noticed 
that  he  did  not  mind  and  sometimes  did 
not  pay  any  attention  to  her  when  he  was 
spoken  to.     Upon  being  brought  to  me,   I 
found  that  he  had  an  inflammation  of  both 
eardrums  and  the   hearing   was  very  much 
impaired  by  the  process.     The  proper  treat- 
ment soon  remedied  the  condition.     Adenoids 
are   the   most   frequent    cause   of   impaired 
hearing  in  children. 

An  acute  inflammation  or  abscess  of  the  Earache 
ear,  if  untreated,  may  leave  a  child  with  o?  the  Ear8* 
poor  hearing  or  even  entirely  deaf.  Any 
symptoms  referable  to  the  ear  or  any  dis- 
charge from  the  ear  should  be  attended  to 
at  once.  Children  are  very  prone  to  such 
trouble  with  the  ear.  It  usually  begins 
with  earache,  which  in  the  infant  is  not  always 
easy  to  diagnose.  It  is  often  accompanied  by 
such  severe  pain  that  the  child  gets  no  sleep 
at  all.  He  cries  night  and  day  until  the 
abscess  breaks  or  until  it  is  lanced.  When 
this  pain  is  not  present  and  the  child  has 


134  THE   HEALTHY   BABY 

fever,  loss  of  appetite  and  restlessness, 
nothing  but  an  examination  of  the  ear  will 
locate  the  trouble.  Putting  the  hand  to  the 
ear  is  not  a  sign  of  earache  in  very  young 
babies,  as  most  mothers  think  it  is.  In  fact, 
a  child  under  three  years  cannot  locate  pain 
very  accurately. 

Best       The  best  treatment  for  earache  is  a  hot 

for  Earache,  irrigation  with  two  quarts  of  water  from  a 

fountain  syringe.     This  is  followed  by  the 

application  of  the  hot-water  bag  until  the 

physician  takes  charge. 

THE  SKIN 

Keeping       IT  is  a  wonder  to  me  that  the  baby's  skin 

ii^Good  does  not  suffer  more  often  than  it  does  when 

Condition.  we  QQjjgj^gj.  that  ne  js  we^  a  certain  amount 

of  the  time  in  spite  of  all  the  care  we  may 
give  him.  The  child's  skin  certainly  is 
delicate  and  needs  a  great  deal  of  care  to 
keep  it  in  good  condition.  Bathing  and 
the  use  of  castile  soap  upon  the  healthy  skin 
keeps  it  in  good  condition.  The  soap  should 
be  thoroughly  washed  off  in  the  bath  and  a 
generous  application  of  toilet  powder  (es- 
pecially in  the  folds  of  his  fat  little  body) 


THE    SKIN  135 

made  after  the  bath  and  every  time  we  have 
occasion  to  dry  him.  During  the  hot 
weather  this  is  more  necessary  than  ever. 
Strong  brown  soap  used  in  the  washing  of 
diapers  and  other  clothing  which  comes  in 
contact  with  skin  often  causes  trouble. 

The  girl's  complexion  should  be  carefully  The  Girl's 
attended  to,  for  what  is  more  delightful  than 
the  clear  healthy  skin  of  the  young !  The 
cold  bleak  winds  of  the  northern  climate 
make  chapping  a  frequent  occurrence,  which 
leaves  in  its  wake  a  rough  coarse  skin. 
Daily  applications  of  cold  cream  both  morn- 
ing and  night  will  not  only  give  the  child 
comfort,  but  insure  a  good  complexion  as 
she  grows  older.  Any  pimples  are  usually 
caused  by  overeating  or  some  error  in  diet. 
This  should  not  be  allowed  to  go  on,  as  the 
young  girl  may  be  marked  for  life  by  neglect 
of  pimples  when  they  first  appear. 

There  is  one  thing  that  I  never  offer  an  Eruption*, 
opinion  upon  until  I  have  seen  it  and  studied 
it  myself  —  and  that  is  an  eruption  upon  the 
skin.  The  eruptive  diseases  may  do  so 
much  harm  that  it  is  not  well  to  take  a  chance. 
It  is  so  easy  for  the  mother  to  say  she  thinks 


13()  THE    HEALTHY   BABY 

it  is  only  a  stomach  rash  or  prickly  heat. 
She  does  not  forgive  herself  easily  when  she 
finds  out  later  that  it  is  scarlet  fever. 
Eruptions  are  often  difficult  for  the  well- 
trained  physician  to  diagnose,  so  the  mother 
should  not  expect  to  become  proficient  in 
distinguishing  the  different  varieties  herself. 
My  one  warning  would  be  not  to  let  any  acute 
eruption  go  undiagnosed. 

Chronic  Chronic  eruptions,  too,  should  not  be  al- 
>ns'  lowed  to  go  on.  For  instance,  an  eczema 
which  starts  in  a  fold  of  the  skin  may  spread 
over  the  whole  body  and  be  a  very  difficult 
thing  to  treat  after  it  has  become  so  exten- 
sive, or  even  after  it  has  become  chronic  over 
a  small  area.  A  child  with  eczema  should  not 
have  a  full  bath,  because  soap  and  water  are 
very  harmful  to  the  inflamed  skin,  particu- 
larly the  soap.  The  diet  is  usually  at  the 
bottom  of  the  trouble  in  some  way,  even  in 
the  breast-fed  baby. 

Prickly  Prickly  heat  is  due  to  too  much  clothing  or 
rough  things  coming  next  the  skin,  which,  of 
course,  involves  over  heating.  Dress  the 
baby  as  coolly  as  possible  and  put  sodium 
bicarbonate  (cooking  soda)  into  the  bath, 


THE   HAIR  137 

a  tablespoonful  to  the  gallon  of  water. 
Powder  the  body  thoroughly  many  times  a 
day  with  talcum  powder  which  has  boracic 
acid  added  to  it,  say  a  couple  of  teaspoonfuls 
to  the  usual  one-ounce  box  of  powder. 

THE  HAIR 

GIRLS  especially  are  dependent  upon  the 
hair  for  attractiveness  in  later  life,  and  since 
we  wish  to  start  our  children  off  with  all  the 
physical  perfections  possible,  it  is  well  to 
devote  a  certain  amount  of  attention  to 
this  "  crowning  glory." 

After  the  hair  has  come  thick  upon  the  The 
head,  it  is  not  well  to  wet  it  every  day  at 
the  bath  time.  One  shampoo  a  week  is 
sufficient,  and  if  the  hair  is  dry  and  brittle, 
once  in  two  weeks  is  often  enough.  Castile 
soap  is  best  for  the  shampoo,  as  some  of 
the  stronger  soaps,  while  they  remove  the 
oil,  tend  to  make  the  hair  break  off. 

"Shall  I  cut  my  girl's  hair?"  is  frequently  Effect  of 


asked  me.     If  the  hair  is  very  thin,  it  does         0* 
sometimes  make  it  thicker  to  cut  it;    but 
frequent  cutting  does  often  spoil  the  natural 
curl  in  later  life.     While  I  do  not  believe  in 


138  THE    HEALTHY   BABY 

sacrificing  comfort  and  health  for  beauty,  I 
must  admit  I  admire  beauty;  comfort  can 
be  attained  by  cutting  the  back  hair  a  few 
inches  so  that  the  neck  will  not  be  too  warm. 
The  discomfort  from  a  heated  head,  moreover, 
is  not  very  great. 

Frequent       Frequent  brushing  of  the  hair  tends  to 

iTsem^  m&ke  it  healthy  and  vigorous.     Taking  the 

ficiai.  snaris  out  with  a  comb  is  ruinous,   for  it 

breaks  off  and  pulls  out  so  much  that  the 

hair   soon   looks   thin   and   scraggly.     Long 

hair  never  need  interfere  with  the  sleep  as 

we  are  sometimes  told  if  it  is  properly  braided 

and  tied  out  of  the  way  at  bedtime. 

Milk       During  the  first  year,  the  scalp  is  often 

Crust  in  .  .  .    .  , 

the  Scalp,  covered  with  a  coating  which  is  called 
milk  crust.  This  is  a  great  source  of  dis- 
comfort to  the  child,  and  a  worry  to  the 
mother.  It  should  receive  energetic  treat- 
ment as  soon  as  it  is  noticed.  Stop  washing 
the  scalp  altogether,  for  I  believe  that  it  is 
often  caused  by  excessive  cleanliness  in  this 
direction.  The  crust  should  be  softened  by 
rubbing  in  a  generous  supply  of  cold  cream. 
After  it  is  all  loosened  in  this  way,  a  soft 
piece  of  linen  covered  with  cold  cream  is  used 


THE    GENITAL   ORGANS  139 

to  remove  the  crust.  Then  a  fresh  applica- 
tion of  cold  cream  is  applied  and  repeated 
two  or  three  times  a  day.  Each  morning 
clean  away  any  of  the  crust  that  has  accumu- 
lated. If  there  is  much  hair,  it  should  be  cut 
close  to  the  scalp.  After  the  condition  is 
cured,  be  careful  not  to  wash  the  head  too 

often. 

THE  GENITAL  ORGANS 

A  GREAT  deal  of  care  is  necessary  in  keeping  Care  of 
the  genital  organs  of  the  girl  baby  free  from  Genitals.8 
any  irritation.  Any  inflammatory  condition 
which  begins  here,  not  only  causes  discom- 
fort, but  occasionally  spreads  upward  to  the 
bladder  and  kidneys,  thus  resulting  in  a 
more  or  less  serious  condition.  The  vagina 
should  be  carefully  washed,  at  the  time 
of  the  bath,  with  boracic  acid  and  a  clean 
piece  of  cotton.  For  this  purpose  never  use 
the  washcloth,  or  the  soap  and  water  which  is 
used  for  the  bath.  It  is  also  necessary  to  wash 
the  vagina  toward  the  rectum,  so  that  it  will 
not  become  contaminated  with  the  matter  from 
the  stool.  Care  should  also  be  taken  that  the 
clothing,  especially  after  the  girl  has  become  old 
enough  to  wear  drawers,  is  not  too  tight,  so 


140  THE    HEALTHY   BABY 

that  these  parts  will  be  chafed.  Occasionally 
adhesions  are  found  between  the  lips  of  the 
orifice,  where  they  are  joined  together  above. 
These  are  apt  to  cause  the  so-called  "reflex 
symptoms,"  such  as  restlessness,  nervousness, 
frequent  passing  of  urine,  and  even  con- 
vulsions. Any  symptoms  of  this  sort  call 
for  an  examination  by  the  physician,  who  will 
separate  the  adhesions.  If  at  any  time  the 
parts  look  red  and  irritated,  the  cause  should 
be  looked  into,  and  the  proper  treatment  in- 
stituted at  once.  A  frequent  cause  of  such 
irritation  is  pinworms,  and  when  they 
are  present,  there  is  apt  to  be  an  itching 
about  the  rectum  as  well.  If  there  is  any 
discharge  at  any  time,  it  should  be  attended 
to  at  once. 

The  genital  organs  of  boys  do  not  as  a 
rule  need  so  much  attention,  although  it 
has  been  more  or  less  of  a  fad  in  recent 
years  to  regard  circumcision  as  a  routine 
necessity.  I  believe  that  the  matter  has 
been  very  much  overdone.  Every  boy  is 
born  with  the  prepuce  adherent  or  glued 
together,  but  this  does  not  as  a  rule  interfere 
with  the  proper  flow  of  the  urine.  I  do 


THE    GENITAL   ORGANS  141 

aot  believe  that  nature  could  go  so  far  astray 
as  to  make  this  condition  almost  universal 
if  it  were  a  harmful  one,  and  I  therefore 
advise  no  interference  unless  symptoms  arise 
which  require  it.  Such  symptoms  are  fre- 
quent urination,  fretfulness,  or  any  sign 
of  irritation  about  the  orifice.  Sometimes 
the  foreskin  is  so  long  that  a  drop  of  urine 
remains  in  the  canal  after  urination,  and 
this  often  means  that  a  circumcision  is 
necessary.  This,  however,  is  not  a  common 
occurrence.  At  the  end  of  the  first  year 
it  is  well  to  free  the  adhesions,  so  that 
the  foreskin  can  be  drawn  back  easily.  After 
this  has  been  done,  it  is  necessary  to 
wash  the  parts  thoroughly  with  a  boracic 
acid  solution  each  day  at  the  time  of  the 
bath,  and  keep  them  clean  the  same  as  you 
would  any  other  part  of  the  body.  The 
older  boys  particularly  need  this  care,  as 
any  lack  of  cleanliness  permits  the  re- 
tention of  the  secretions  which  are  apt  to 
form  behind  the  foreskin,  and  may  cause 
an  inflammatory  condition,  bed- wetting,  or 
even  masturbation.  The  latter  is  a  subject 
which  I  have  not  dealt  with  in  this  book 


142  THE   HEALTHY   BABY 

because   I   think   the   physician   should   be 
consulted  frankly  and  unhesitatingly  if  the 
occasion  arises. 
Un-       The   subject   of  undescended    testicles  is 

'•JSicies.  one  wnich  snould  be  touched  upon  here.  If 
one  or  both  of  the  testicles  cannot  be  felt 
in  the  scrotum,  the  probability  is  that  they 
are  either  in  the  canal  which  leads  from  the 
abdomen,  or  they  are  in  the  abdomen  itself. 
If  they  do  not  cause  any  pain  in  such  a  posi- 
tion, no  treatment  is  necessary  during  the 
first  year,  but  after  that  the  physician  should 
be  consulted,  and  the  condition  remedied 
by  operative  procedures  if  necessary.  If 
there  is  pain,  the  matter  should  receive  im- 
mediate attention. 

Retention  A  condition  which  seems  to  give  the  mother 
a  great  deal  of  worry  is  that  of  retention  of 
urine.  The  mother  thinks  the  child  does  not 
pass  the  urine  often  enough,  or  perhaps  none 
at  all  is  passed  for  twelve  or  even  twenty-four 
hours.  This  is  most  apt  to  occur  during 
an  illness  of  some  sort,  and  it  is  most  fre- 
quently due  to  the  small  amount  of  liquids 
that  the  child  has  taken.  Naturally  when 
the  child  does  not  take  the  usual  amount  of 


THE    GENITAL   ORGANS  143 

milk  or  water,  there  cannot  be  as  much 
urine  eliminated  by  the  kidneys,  so  that  it 
should  not  be  a  real  cause  of  worry.  Usually 
it  is  not  necessary  to  do  anything,  but  after 
twelve  hours,  if  no  urine  has  been  passed, 
hot  cloths  may  be  placed  over  the  region 
of  the  bladder.  Probably  in  one  out  of  a 
hundred  cases  that  I  see  where  this  condition 
is  complained  of,  there  is  something  the  matter 
other  than  this,  and  then  the  physician  should 
be  called. 


PART  V 
FEEDING  AND  DIET 


BREAST  FEEDING 

THE  mother's  milk  is  the  only  food  that  Every 
was  ever  meant  for  a  baby  during  his  first  should 


year,  and  any  other  food  is  at  best  a  poor 
substitute.  I  look  upon  the  breast  milk  as  Possible. 
a  true  elixir  of  life.  If  we  knew  how  to  make 
it  and  were  able  to  distribute  it  in  its  purity, 
just  as  it  flows  from  the  mother's  breast, 
we  could  save  thousands  upon  thousands  of 
babies'  lives  each  year.  Can  you  imagine 
a  mother  so  indifferent  to  her  child's  health 
and  life  as  deliberately  to  throw  away  this 
precious  fluid  ?  I  am  happy  to  say  that  I 
have  seen  but  few.  Most  of  the  mothers  I 
meet  are  glad  and  anxious  to  nurse  their 
babies.  It  is  usually  lack  of  knowledge 
which  leads  them  to  loss  of  this  milk.  Dur- 
ing the  first  two  or  three  days  there  does  not 
seem  to  be  much  of  anything  in  the  breasts, 
but  if  we  observe  carefully  we  will  find  that 
there  is  a  thin  watery  fluid  there.  This  is  all 
the  nourishment  the  baby  requires  at  this  time. 
Do  not  give  him  water  (either  sweetened  or 
plain),  or  milk,  or  anything  else.  These  things 
give  him  colic,  and  when  his  stomach  is  full 
he  will  not  take  hold  of  the  nipples.  Put  him 

147 


148  THE    HEALTHY   BABY 

to  the  breast   once   in  four  hours  whether 
there  seems  to  be  anything  there  or  not. 
The  Baby's       The  young  mother  should  first  of  all  guard 
dependent  ner  own  good  health  for  the  sake  of  the  baby, 


nu    e  if  no*   f°r  herself.     She  should   keep   good 

Mother  s. 

hours  and  get  plenty  of  sleep.  She  should 
not  change  her  habits  too  much  (if  they  have 
been  good  ones).  If  she  has  been  accustomed 
to  much  walking  or  other  outdoor  life,  she 
should  not  give  it  up.  If  she  has  been  used 
to  playing  golf  or  riding,  or  going  about 
socially,  or  doing  housework,  she  should  not 
suddenly  change  her  mode  of  life  unless,  as  I 
say,  if  it  is  for  the  better.  A  certain  amount 
of  exercise  helps  the  milk  in  quantity  and  qual- 
ity. If  the  mother  has  not  been  accustomed 
to  exercise  before  the  baby  was  born,  she 
should  begin  to  take  a  little  each  day  after- 
ward, gradually  increasing  the  amount  of 
exercise,  perhaps  by  walking  a  little  farther 
each  day,  but  always  being  careful  to  stop 
just  short  of  the  point  where  she  gets  tired. 
Fatigue  should  be  avoided.  A  woman  who 
has  led  an  active  society  life  is  apt  to  become 
discontented  if  she  gives  it  up  entirely.  She 
should,  therefore,  not  be  persuaded  to  eschew 


BREAST   FEEDING  149 

it  altogether.  The  sleep  is  apt  to  be  broken 
by  the  night  nursings  so  that  a  nap  in  the 
daytime  is  advisable.  At  any  rate  see  that 
the  proper  amount  of  sleep  is  taken. 

Nervous,  neurotic  mothers  are  not  good  Nervous 
nurses.  The  slightest  distress  upsets  them, 
spoils  the  milk  for  the  time  being,  and  makes  Nurses 
the  baby  sick.  Nursing  mothers  who  are  so 
constituted  should  try  to  overcome  the  tend- 
ency and  make  every  effort  to  lead  a  quiet, 
placid  life.  Fortunately,  the  more  or  less 
athletic  mother  of  the  present  generation  is 
a  far  better  nurse  than  was  the  Jane  Austen 
type  of  the  past  generation,  and  I  believe 
she  is  the  salvation  of  her  race. 

The  nursing  mother's  diet  is  the  one  thing  The 
that  seems  oftenest  to  go  wrong.  Every 
one  she  meets  tells  her  of  some  article  of  food  Diet- 
she  should  not  eat,  until,  if  she  obeys  all  the 
advice  she  receives,  the  poor  mother  has  little 
left  in  her  dietary  which  she  dares  to  eat. 
Each  part  of  the  country,  too,  has  different 
notions  about  foods  that  are  injurious  to 
mother  and  child.  In  one  place  it  is  fish,  in 
another  fresh  vegetables  or  sour  things  or 
sweets.  My  advice  to  the  nursing  mother  is 


150  THE    HEALTHY   BABY 

to  avoid  all  excesses  in  eating,  and,  that  being 
done,  to  eat  the  food  to  which  she  has  been 
accustomed  before  the  baby  was  born,  if  it 
gives  her  no  indigestion.  Fish  occasionally, 
and  plenty  of  meat  are  good  milk  makers, 
and  fresh  green  vegetables  are  a  necessity 
where  there  is  a  tendency  to  constipation. 
The  bowels  of  the  breast-fed  baby  depend 
upon  the  condition  of  the  mother's  bowels, 
as  does  his  general  nutrition.  Every  nurs- 
ing mother  should  have  at  least  one  good 
evacuation  each  day.  Usually,  unless  she 
is  habitually  constipated,  plenty  of  fruits 
and  vegetables  will  remedy  any  deficiency  in 
this  direction.  Sour  things  are  harmless 
except  when  eaten  in  excessive  quantities. 
Certain  mothers,  like  all  of  us,  do  have 
idiosyncrasies  of  digestion,  and  when  they 
find  that  any  particular  article  of  food  dis- 
agrees repeatedly  with  them  or  with  the 
baby,  it  should  be  stopped.  The  diet  should, 
however,  be  a  general  one,  avoiding  monotony 
and  including  the  various  kinds  of  food.  It 
should  also  be  a  generous  one,  since  the 
mother  has  two  bodies  to  nourish  instead  of 
one.  Three  meals  a  day  may  be  sufficient, 


BREAST   FEEDING  151 

but  many  women  feel  the  need  of  a  little 
hmch  in  the  middle  of  the  morning  and  in  the 
afternoon.  If  this  does  not  take  the  appetite 
away  from  the  regular  meals,  it  is  a  very 
good  thing. 

Milk  may  be  drunk  between  the  meals  or  Milk  and 
with  them,  except  where  it  is  taken  to  the  Liquids  for 
exclusion  of,  or  spoils  the  appetite  for  other  JJ.U" nng 

Mothers. 

food,  or  where  it  disagrees  with  the  stomach 
or  causes  constipation.  When  milk  is  well 
borne,  however,  it  is  a  great  help  in  increasing 
a  deficient  milk  supply.  Cornmeal  and  oat- 
meal gruels  are  also  valuable  for  this  purpose 
if  taken  in  sufficient  quantities,  but  not  to 
the  exclusion  of  other  foods.  Plenty  of  liq- 
uids should  be  taken,  but  these,  too,  should 
not  be  overdone.  I  have  known  mothers 
who  have  taken  two  quarts  of  tea  a  day  be- 
cause they  were  told  to  drink  a  lot  of  liquids. 
The  tea  made  them  nervous  and  tied  up  the 
bowels  so  that  the  milk  supply  was  ruined. 
Alcoholic  beverages  are  usually  not  necessary 
and  occasionally  do  harm  to  the  baby.  If 
the  mother  is  accustomed  to  a  moderate 
amount  of  wine  or  malt  liquors,  it  may  also 
agree  with  the  baby,  but  she  should  watch  for 


152  THE    HEALTHY   BABY 

any  signs  of  colic  in  her  offspring  and  give 
up  the  beverage  altogether  if  it  seems  to  be 
disagreeing  with  him.  Occasionally  when 
we  are  sure  the  breast  milk  is  deficient,  a 
glass  of  ale  or  porter  with  the  meals  will  in- 
crease the  milk  supply. 

The  Breast-  The  question  often  comes  up,  "Is  it  ad- 
nmy  have  visable  to  give  the  baby  a  bottle  or  two  so 
or  Two.1"  tnat  tne  motner  may  get  a  rest  or  possibly 
a  little  recreation  from  her  constant  and 
arduous  duties  as  mother  and  wet  nurse?" 
I  believe  it  is.  In  the  first  place,  the  mother, 
if  she  so  desires,  has  some  rights  to  a  few  hours 
of  freedom  from  her  baby  each  day.  In  the 
second  place,  it  is  well  to  accustom  the  baby 
to  taking  his  food  from  the  bottle  in  case  an 
occasion  should  arise  where  it  is  impossible 
to  feed  the  baby  from  the  breast.  This 
should  be  done  with  the  advice  of  a  physician, 
lest  we  give  a  food  that  is  not  good  for  the 
baby. 

Care  of  the       The  breasts  and  nipples  themselves  should 

Nipple*  be  well  cared  for.     The  nipples  should  never 

be  touched  or  handled  until  the  hands  have 

been  scrubbed  with  soap   and  a  nailbrush. 

The  penalty  of  disobedience  of  this  rule  may 


BREAST   FEEDING  153 

be  an  abscess  of  the  breast.  During  the  first 
weeks  especially  the  nipples  are  unaccus- 
tomed to  the  constant  moistening  and  pulling 
which  the  baby  gives  them.  The  skin  is 
apt  to  become  soft  and  tender,  and  when  in 
this  condition  the  breasts  are  easily  infected 
by  the  nurse  or  mother  who  also  handles  the 
stools  of  the  baby.  After  each  nursing,  the 
nipples  are  washed  with  a  solution  of  boracic 
acid  and  boiled  water,  one  teaspoonful  to  the 
pint.  They  are  then  thoroughly  dried  and 
a  large  piece  of  sterile  gauze  laid  over  the 
nipples  so  that  they  will  not  come  in  contact 
with  the  clothing.  Corsets  should  be  worn 
which  are  either  high  enough  to  support  the 
whole  breast  and  taken  off  while  nursing,  or 
low  enough  so  that  the  breasts  are  not  rubbed 
and  irritated  by  the  upper  edge. 

When  a  nipple   becomes   so   tender  that  Use  of  the 
nursing  is  very  painful  or  when  there  is  a  sSd. 
crack  or  fissure  in  it,  the  child's  mouth  should 
not  be  allowed  to  touch  it  at  all.     Instead 
the  nipple  shield  is  used.    The  best  kind  is 
made  of  glass  with  a  rubber  nipple  on  the 
end  of  it.     The  sore  nipple  should  not  be 
moistened   with   the   boracic   acid   solution, 


154  THE    HEALTHY   BABY 

but  instead  it  should  be  kept  continuously 
covered  with  zinc  oxide  ointment ;  with  this 
treatment  (if  begun  at  the  start)  the  nipple 
will  be  healed  in  a  few  days  and  the  nipple 
shield  can  be  discarded. 

How  often  The  quality  and  quantity  of  the  milk,  as 
8  Nursings  well  as  the  condition  of  the  breast,  depends 
Come?  ajgo  UpOn  foe  manner  and  the  frequency  of 
nursing.  When  the  child's  mouth  is  put  to 
the  nipple,  the  breast  is  stimulated  to  activity 
by  this  natural  act.  For  this  reason  a  breast 
does  not  secrete  as  much  milk  when  the  breast 
pump  or  nipple  shield  is  used,  and  if  either 
is  used  for  any  length  of  time,  it  may  spoil 
the  milk  supply  altogether.  In  the  same  way 
a  child  that  is  put  to  the  breast  every  time 
he  cries,  not  only  upsets  his  own  digestion 
but  spoils  the  milk.  The  intervals  should 
be  regulated,  therefore,  as  soon  after  birth 
as  it  is  possible  to  do  so.  The  question  of  how 
often  the  nursings  should  come  depends  upon 
•  the  size,  strength,  and  age  of  the  baby  and 
upon  the  quality  and  quantity  of  the  milk. 
This  is  often  a  question  which  the  physician 
must  decide,  but  in  general  a  small  weak 
baby  should  be  nursed  every  two  hours  from 


WEANING  155 

6  A.M.  until  10  P.M.,  with  one  feeding  at 
2  A.M.,  making  ten  nursings  in  twenty-four 
hours.  A  strong  fat  baby  may  from  birth 
be  nursed  every  three  hours  from  6  A.M.  to 
9  P.M.,  which  with  the  2  A.M.  feeding  makes 
seven  in  twenty-four  hours.  At  three  months 
of  age  the  baby  should,  if  he  has  gained  in 
weight  properly,  even  though  he  was  small 
at  the  start,  be  put  upon  the  three  hour 
nursing  schedule.  At  four  months,  if  he  is 
a  normal  well  child,  he  should  not  be  nursed 
at  all  between  9  P.M.  and  6  A.M.  This  gives 
him  six  feedings  in  twenty-four  hours,  which 
is  sufficient  throughout  the  first  year. 

WEANING 

BY  weaning  I  mean,  of  course,  both  dis-  when 
carding  the  breast   for  the  bottle  or  for  a  Feeding 
general  diet,  and  discarding  the  bottle  for  a  g^^j 
general  diet.     Substituting  the  bottle  for  the 
breast  is,  perhaps,  the  most  important  part 
of  this  subject,  because  it  is  done  so  frequently 
during  the  first  year  when  there  is  no  neces- 
sity of  taking  such  a  radical  and  often  dis- 
astrous step.     When  it  is  necessary  to  stop 
the  breast,  however,  it  should  be  done  without 


156  THE    HEALTHY   BABY 

any  hesitation.  There  are  certain  definite 
indications  for  such  a  procedure  and  they  are 
as  follows :  (1)  Excessive  vomiting  ac- 
companied by  loss  of  weight,  or  by  stationary 
weight  extending  over  a  period  of  two  weeks 
or  more.  (2)  A  bad  diarrhea  which  can- 
not be  remedied  while  the  baby  is  breast- 
fed, and  accompanied  by  loss  of  weight  or 
by  stationary  weight  extending  over  a  period 
of  two  weeks  or  more.  Loose  bowels  alone, 
especially  when  there  is  a  progressive  gain 
in  weight  and  the  proper  general  develop- 
ment, is  not  an  indication  for  discontinuing 
the  breast.  (3)  Progressive  loss  of  weight 
or  stationary  weight  extending  over  a  period 
of  three  weeks  or  more  while  the  digestion 
seems  normal.  (In  all  of  these  conditions 
every  effort  should  be  made  to  overcome 
them  while  the  child  remains  on  the  breast. 
It  is  also  important  that  these  things  do  not 
arise  from  an  acute  illness  of  the  baby  aside 
from  that  due  to  a  poor  milk  supply.)  (4) 
A  serious  disease  of  the  mother. 
Baby's  In  my  discussion  of  breast-feeding  it  may 
Bestride  appear  as  though  I  thought  that  all  mothers 
m  Weanmg.  CQU\^  nurse  their  babies  if  they  so  desired. 


WEANING  157 

I  wish  that  this  were  so,  but  it  is  not.  And 
when  shall  we  know  that  the  baby  is  not  get- 
ting sufficient  nourishment  from  the  breast  ? 
First  of  all,  from  the  weight.  When  a  breast- 
fed baby  ceases  to  gain  in  weight,  we  look 
about  for  a  reason.  Is  he  fed  at  regular 
intervals?  Is  he  vomiting?  Has  he  any 
intestinal  indigestion,  as  shown  by  bad  stools  ? 
Is  the  mother's  diet  a  correct  one,  are  her 
bowels  in  good  condition,  and  is  she  paying 
the  proper  attention  to  all  the  details  of  the 
baby's  daily  routine,  including  nursing  at 
regular  intervals?  These  things  we  regu- 
late to  the  best  of  our  ability  and  still  the 
baby  does  not  gain  in  weight.  Even  then 
we  stick  to  the  elixir  of  life,  the  breast  milk, 
and  add  to  this  a  few  bottles  of  the  properly 
modified  milk  each  day  to  see  if  we  may  rem- 
edy the  conditions  and  get  a  gain  in  weight 
and  good  stools  and  no  vomiting.  After  a 
faithful  trial  of  all  these  things,  we  bravely 
step  forward  and  defy  nature,  or  rather  the 
present  artificial  mode  of  living,  and  take 
up  the  task  of  nourishing  this  baby  with  as 
much  faith  in  our  success  as  our  experi- 
ence will  allow.  It  requires  a  great  deal  of 


158  THE    HEALTHY   BABY 

experience  to  acquire  sufficient  confidence 
in  one's  self  to  step  in  and  assume  the  role 
of  nature.  Therefore,  I  would  advise  mothers 
and  nurses  to  go  slowly  without  medical 
advice.  After  many  years'  experience  in  in- 
fant feeding,  I  still  find  cases  that  require 
the  utmost  resourcefulness  to  enable  me  to 
make  some  of  my  babies  do  well  on  the  bottle, 
may  The  first  few  weeks  after  the  baby  is  born, 
insufficient  it  may  appear  as  though  the  breast  milk  was 
insufficient>  but  we  must  not  be  too  easily 
discouraged.  It  is  a  trying  period  and  con- 
ditions are  never  at  their  best.  The  mother 
has  endured  the  hardships  of  the  labor  and 
she  is  in  bed  at  least  convalescing,  if  not  ill. 
Where  there  is  any  question  of  discontinuing 
the  breast  at  this  time,  we  should  wait  until 
the  mother  is  up  and  about  and  living  her 
normal  natural  life  again  before  we  decide 
to  start  upon  the  bottle.  Often  the  milk 
supply  increases  at  once  when  the  getting-up 
time  comes.  Of  course,  if  there  is  a  con- 
tinuous loss  in  weight  after  the  usual  loss  of 
the  first  three  days,  this  waiting  policy  should 
not  be  adopted.  In  fact,  continuous  loss  of 
weight  at  any  period  of  the  baby's  life  is 


WEANING  159 

sufficient  reason  either  to  stop  the  breast 
or  add  supplementary  bottle  feedings.  The 
same  may  be  said  of  stationary  weight  ex- 
tending over  a  period  of  two  to  four  weeks. 

I  would  not  give  the  impression  that  all 
mothers  are  able  to  furnish  sufficient  nour- 
ishment for  their  babies  throughout  the  first 
year,  for  many  seem  to  do  well  until  the  latter 
half  of  this  period,  when  the  milk  supply  gives 
out  in  spite  of  all  we  can  do. 

There  are  certain  conditions  arising  in  the  when  the 
mother  when  it  is  necessary  to  discontinue  Mother  gete 
the  breast,  for  we  should  have  some  con-  Sick- 
sideration  of  her  welfare.  Any  acute  illness 
with  fever  is  apt  to  spoil  the  milk  supply  for 
a  time,  as  well  as  to  be  an  extra  drain  upon 
the  mother's  strength,  so  that  it  is  well  to 
stop  the  breast  while  it  lasts.  If  the  illness  is 
short,  the  breast  feeding  may  be  resumed  upon 
its  abatement.  Throughout  such  an  illness 
the  breasts  should  be  pumped  out  with  the 
breast  pump  at  regular  intervals,  usually  once 
in  three  hours.  This  is  to  prevent  the  breasts 
from  drying  up  while  the  mother  is  too  sick  for 
the  baby  to  nurse  her.  A  chronic  disorder  of 
any  consequence  is  an  indication  for  giving 


160  THE    HEALTHY   BABY 

up  the  breast  permanently.  Tuberculosis, 
kidney  disease,  anaemia,  epilepsy,  grave 
mental  disorders,  progressive  loss  of  weight 
in  the  mother,  and  pregnancy  all  point 
toward  a  discontinuance  of  the  breast 
feedings.  The  return  of  menstruation  is 
usually  not  accompanied  by  any  alteration 
in  the  milk  supply.  It  may  occasionally 
give  rise  to  a  slight  disturbance  in  the 
baby's  digestion  for  a  day  or  two,  but 
unless  there  is  a  decided  and  permanent 
change  for  the  worse  in  the  baby,  the  breast 
should  not  be  discontinued  on  this  account. 
Teaching  When  we  have  finally  decided  that  the 
ohus?^e  baby  must  be  weaned  from  the  breast,  our 
Bottle,  troubles  are  not  over  by  any  means,  for  we 
must  then  select  the  proper  food  and  we  have 
got  to  teach  the  baby  to  take  his  nourish- 
ment from  the  bottle.  The  bottle  and  nipple 
should  always  be  used  in  a  child  under  ten 
months  of  age  if  the  breast  is  given  up  al- 
together, for  he  cannot  at  this  age  get  suffi- 
cient nourishment  from  the  cup  or  spoon. 
If  he  has  already  learned  to  take  the  bottle 
during  his  breast-fed  days,  as  I  have  sug- 
gested, the  task  is  easy.  But  if  he  stub- 


WEANING  161 

bornly  resists  all  our  efforts  to  give  him  sus- 
tenance in  this  artificial  manner,  a  struggle 
is  ahead  of  us.  I  am  often  obliged  to  get  a 
trained  nurse  for  these  trying  days  until  he 
has  learned  to  take  the  bottle.  However, 
if  one  is  persistent  and  will  not  give  in  to  the 
little  fellow,  allowing  no  nourishment  in  any 
other  way  for  one  or  two  days,  he  soon  learns. 
The  hole  in  the  nipple  should  be  very  large 
so  that  the  milk  will  run  into  his  mouth  with- 
out much  sucking  until  he  has  learned  to 
work  for  it. 

After  ten  months  or  a  year  it  is  far  easier  The  Proper 
to  wean  the  baby,  because  if  he  has  done  well 
up  to  this  time  and  is  strong  and  well,  he  may 
take  milk  out  of  the  cup,  eat  cereals  and  other 
soft  foods.  In  fact,  as  a  matter  of  education, 
it  is  well  to  teach  the  child  to  drink  out  of  a 
cup  or  eat  cereals  or  stale  bread  while  he  is 
still  doing  well  on  the  breast,  say  at  nine 
months,  so  he  will  take  to  it  kindly  when  the 
time  comes  to  wean  him.  It  is  extremely  rare 
to  find  a  mother  who  can  nurse  her  baby 
after  the  first  year.  Mothers  often  do  it,  but 
children  who  are  nursed  too  long  cease  to 
gain  in  weight,  their  muscles  become  flabby, 


162  THE    HEALTHY   BABY 

and  they  soon  begin  to  suffer  from  rickets, 
anaemia  or  some  other  form  of  malnutrition. 
Some  of  the  worst  cases  of  poor  nourishment 
I  see  in  children  over  a  year  are  due  to  nursing 
during  the  second  year. 

When  should  a  child  be  weaned  from  the 
bottle  ?  Like  the  breast-fed  baby,  he  should 
Baby.  Degjn  to  receive  some  food  from  the  cup  or  a 
spoon  at  about  nine  months,  if  he  is  up  to  the 
standard  in  weight  and  health.  At  a  year 
he  can  get  one  whole  feeding  in  this  way  and 
consequently  one  less  bottle  feeding.  At 
fourteen  months  he  can  get  sufficient  nour- 
ishment with  three  feedings  from  the  bottle 
and  two  meals  of  soft  food.  At  sixteen 
months,  three  meals  a  day  and  one  bottle 
at  10  P.M.  will  suffice.  At  eighteen  to 
twenty  months,  the  ten-o'clock  bottle  is 
stopped  and  baby  is  weaned. 

THE  BOTTLE  AND  NIPPLES 

THE  first  thing  that  concerns  us  when  we 
>D  Care  of  find  we  have  a  bottle  baby  on  our  hands  is 


Bottles.  fae  selection  and  care  of  the  bottles  and 
nipples  themselves.  The  best  bottles  are 
those  that  are  round  and  cylindrical  and 


THE   BOTTLE   AND   NIPPLES  163 

have  a  narrow  neck  for  the  attachment  oi 
the  nipple.  The  one  important  requirement 
is  that  they  have  no  corners  on  the  inside, 
being  rounded  both  at  the  bottom  and  at 
the  top  where  the  neck  begins.  This  shape 
of  the  inside  of  the  bottle  enables  us  to  clean 
it  thoroughly.  An  improvised  medicine  bot- 
tle should  never  be  used,  as  it  is  absolutely 
impossible  to  clean  out  the  corners.  It  is 
best  to  get  as  many  bottles  as  there  are  feed- 
ings in  twenty-four  hours.  Also  buy  a  wire 
bottle  rack  to  hold  them  when  the  food  is 
made  up  for  the  day.  As  soon  as  the  baby 
has  taken  his  feeding,  wash  out  the  bottle 
with  soap  or  washing  powder,  using  a  long- 
handled  bottle  brush  to  get  it  scrupulously 
clean.  Then  rinse  the  soap  out  with  hot 
water,  and  put  into  the  bottle  a  heaping  tea- 
spoonful  of  borax.  Some  warm  water  is  now 
poured  in  and  the  bottle  is  vigorously  shaken 
until  all  the  borax  is  dissolved.  It  is  then 
filled  brimming  full  of  water  and  allowed  to 
stand  full  of  this  strong  borax  solution 
until  the  next  morning,  when  the  feedings 
are  made  up  for  the  day.  If  each  bottle 
is  treated  in  this  way,  we  have  in  the 


164  THE    HEALTHY   BABY 

morning  the  whole  lot  perfectly  clean  and 
ready  to  be  filled  with  the  day's  feedings  as 
soon  as  the  borax  solution  has  been  poured 
out  and  the  bottles  rinsed  once  with  clear 
'water.  With  this  method  it  is  unnecessary 
to  boil  the  bottles  each  day  and  it  is  a  great 
saving  of  time  and  trouble.  The  bottles 
should  never  be  allowed  to  stand  unclean  or 
filled  with  plain  cold  water  or  even  with  cook- 
ing soda  in  them,  for  borax  is  the  stronger 
and  better  antiseptic  to  use. 
The  Kind  The  nipples  are  important,  too.  For  the 

of  Nipples   ,  .     ,      i     ,  111  i  •       i      • 

and  how  little  baby  we  should  see  that  the  nipple  is 
3C  too  large  or  too  long.     Frequently,   a 


long  nipple  will  gag  him  and  cause  him  to 
vomit  up  the  whole  feeding  just  as  he  has 
nearly  finished  it.  It  is  often  a  very  diffi- 
cult task  to  get  nipples  with  the  right  sized 
holes.  If  the  baby  gets  the  food  too  fast, 
it  may  cause  colic  or  indigestion  or  vomiting, 
so  we  should  select  a  nipple  with  one  hole  in 
it  which  will  be  small  enough  so  that  the 
feeding  cannot  be  taken  in  less  than  twenty 
minutes.  It  is  well  to  have  two  or  three 
nipples  on  hand.  When  new,  they  should 
be  boiled  once.  As  soon  as  the  feeding  is 


MILK  165 

taken,  the  nipple  should  be  filled  with  borax 
and  held  under  the  faucet  while  it  is  being 
rubbed  between  the  thumb  and  fingers.  It 
is  then  placed  in  a  cup  of  water  containing 
one  heaping  teaspoonful  of  borax.  The 
nipples  need  not  be  boiled  out  after  the  first 
'lay,  nor  need  they  be  turned  inside  out  when 

cleaned 

MILK 

FRESH  cow's  milk,  properly  modified,  is  the  what  is 
)nly  food  for  the  bottle  baby.  Nothing  else  ™Good  y 
will  take  its  place.  But  we  should  endeavor  MUk" 
to  get  good  milk.  By  good  milk  I  mean,  in 
the  first  place,  milk  from  cows  that  are  free 
of  tuberculosis,  —  tuberculin-tested  cows. 
The  cows  should  have  plenty  of  air  space. 
The  hay  should  not  be  stored  directly  above 
them  where  the  dust  may  sift  down  upon 
the  milker,  nor  should  the  cows  be  hayed 
just  before  milking,  for  the  same  reason. 
The  walls  of  the  cow  house  should  be  white- 
washed two  or  three  times  a  year.  The 
manure  should  be  stored  outside  the  barn. 
The  floors  are  best  made  of  cement  and 
washed  with  a  hose,  but,  of  course,  this  is 
often  impossible  for  the  average  farmer. 


THE    HEALTHY   BABY 

He  can,  however,  sweep  the  floor  each  day, 
sprinkling  it  first.  The  cows  should  be  kept 
clean,  the  flanks  and  bag  wiped  off  with  a 
moist  cloth  before  milking.  The  milker's 
hands  should  be  washed  before  milking  (it 
will  do  them  no  harm  after  his  day's  work). 
He  can  slip  on  a  clean  duster  for  this  part  of 
the  day's  work.  The  milking  pails  should 
be  clean.  The  milk  is  rapidly  cooled  after 
milking  to  at  least  45°  F.  and  put  in  quart 
bottles  that  have  been  boiled  or  sterilized 
and  tightly  covered.  The  bottled  milk  should 
then  be  kept  cool  until  the  milk  is  consumed. 
The  There  is,  of  course,  a  reason  for  all  this 
&from  seeming  nonsense.  Milk  is  a  splendid  food 
Bacteria.  £or  germs>  as  we\\  as  for  babies.  If  the  milk 

is  dirty  to  start  with,  it  is  swarming  with 
bacteria.  If  it  is  allowed  to  remain  warm, 
these  bacteria  multiply  enormously,  so  that 
after  a  few  hours  there  are  as  many  as  five 
or  six  million  in  a  cubic  centimeter  or  a 
quarter  of  a  teaspoonful.  This  is  what 
makes  milk  sour  quickly.  The  products  of 
these  bacteria  are  what  cause  the  vast  ma- 
jority of  bowel  troubles  in  infants  during 
the  summer,  and  they  also  cause  so-called 


MILK  167 

milk  poisoning.  Of  course,  all  bacteria  are 
not  harmful.  To  any  one  who  says  that  the 
method  of  producing  good  milk  just  described 
is  not  practicable,  I  will  answer  that  the  pro- 
gressive farmer  has  proven  to  the  contrary. 
It  is  to  his  credit  that  each  day  he  sends 
thousands  of  quarts  of  perfect  milk  into  New 
York  City  and  many  other  cities  in  this 
country.  This  milk  has  to  come  up  to  the 
standard  of  the  County  Medical  Society  be- 
fore it  is  accepted  as  "certified  milk."  It 
is  subjected  to  repeated  examinations  for 
bacteria  and  rejected  if  the  bacteria  are  found 
in  excess  of  a  stated  number.  From  a  finan- 
cial standpoint  it  is  a  paying  proposition,  as 
such  milk  sells  for  from  15  to  20  cents  a  quart. 
It  is  also  worth  this  extra  price  to  the  baby. 

Pasteurized   and   boiled   milk   have   been  Pasteuriz- 
much  discussed  in  the  press.     By  pasteuriz-  b^i^g 
ing  we  mean  heating  the  milk  to  150°-175°  F.  MDk- 
This  kills  most  of  the  bacteria,  but  it  gives  us 
a  false  sense  of  security,  since  the  milk  will 
soon  become  as  bad  as  ever  if  it  is  not  put 
in  clean  containers  and  kept  cold  just  the 
same   as    any   other   milk.     When   milk   is 
boiled,  it  is  brought  to  the  temperature  of 


J^    168  THE    HEALTHY   BABY 

212°  F.  This,  of  course,  changes  the  taste 
of  the  milk  and  destroys  still  more  bacteria, 
but  not  all  of  them.  A  child  who  takes  noth- 
ing but  boiled  milk  for  a  prolonged  period  of 
time  receives  no  fresh  food  and  is  liable  to 
get  scurvy,  just  as  the  sailor  does  who  eats 
no  fresh  food.  Therefore,  boiled  milk  should 
not  be  used  for  any  length  of  time  if  good 
clean  milk  can  be  had,  and  if  one  can  depend 
upon  the  intelligence  of  the  person  making 
up  the  baby's  food.  At  times,  however, 
these  conditions  are  not  right  and  it  is  best 
to  use  boiled  milk  through  the  summer 
months.  The  tendency  to  scurvy  may  then 
be  overcome  by  giving  the  baby  the  juice  of 
half  an  orange  once  or  twice  a  day,  according 
to  his  age,  unless  he  has  a  diarrhea.  Boiled 
milk  is  also  used  temporarily  in  suitable  cases 
to  make  the  food  more  digestible.  For  this 
reason,  I  usually  advise  boiling  the  new-born 
baby's  milk  for  the  first  two  or  three  weeks, 
and  also  the  milk  of  babies  who  have  diges- 
tive disturbances. 

Milk  from  Milk  from  one  cow  has  its  disadvantages, 
because  if  that  cow  eats  something  wrong 
or  gets  chased  by  a  dog  or  what  not,  the  milk 


MIXING   AND   CAEE   OF   THE   FOOD       169 

is  made  temporarily  indigestible  for  the 
baby.  On  the  other  hand,  the  milk  from  the 
whole  herd  would  be  far  less  liable  to  such 
accidents,  and  it  would  be  more  uniform  from 
day  to  day.  I  would,  therefore,  prefer  milk 
from  the  herd,  if  the  dairy  is  well  conducted. 

MIXING  AND  CARE  OF  THE  FOOD 

IT  is  far  better  for  the  baby  and  easier  for  utensils 
the  mother  if  she  takes  a  certain  time  each 
morning  to  make  up  the  food  for  the  day. 
She  then  does  not  have  to  think  of  it  again 
until  the  next  morning.  All  the  utensils  for 
mixing  the  food  are  kept  in  a  place  by  them- 
selves and  are  not  used  for  any  other  pur- 
pose. The  person  whose  duty  it  is  to  make 
the  food  should  be  responsible  for  their  con- 
dition and  keep  them  clean,  not  trusting  to 
any  one  else.  These  utensils  are  not  many. 
A  cheap  measuring  glass,  or  graduate,  hold- 
ing sixteen  ounces  and  divided  into  ounces, 
is  a  time-saving  device,  which  it  is  well  to 
have.  A  wide-necked  pitcher  that  pours 
well  and  holds  two  quarts,  a  glass  funnel 
which  does  not  fit  too  tightly  into  the  neck 
of  the  nursing  bottles,  a  tablespoon,  regula- 


170  THE   HEALTHY   BABY 

tion  size,  a  new  enamel  saucepan  for  boiling 
the  water  or  gruel  or  food,  and  a  one-quart 
preserving  jar  to  put  the  gruel  or  boiled 
water  away  in  until  it  is  cold.  If  gruel  is 
used  to  dilute  the  milk,  it  may  be  made  the 
night  before  so  that  it  will  be  ice  cold  before 
it  is  added  to  the  milk. 

The  First,  the  bottles,  one  for  each  feeding 
les-  throughout  the  day,  are  attended  to.  They 
are  all  clean  and  standing  full  of  borax 
water  from  the  day  before.  The  bottle 
rack  is  held  over  the  sink,  and  the  bottles, 
one  at  a  time,  are  placed  in  it  upside  down 
to  empty  the  borax  water.  They  are  then 
turned  right  side  up  in  the  rack  and  filled 
with  hot  water  to  rinse  out  the  borax  and 
again  placed  upside  down  to  drain  and  cool 
while  the  food  is  being  mixed. 
Mixing  the  The  fresh  unopened  bottle  of  milk  is  then 

Food  for 

the  Day.  poured  into  the  pitcher  so  that  the  cream 
will  be  mixed  in  thoroughly,  and  then  poured 
back  again  into  the  bottle  in  which  it  came. 
Measure  the  proper  amount  of  milk  in  the 
graduate  and  pour  it  into  the  pitcher.  Meas- 
ure out  the  proper  amount  of  ice-cold  water 
or  gruel  and  pour  it  into  the  pitcher.  Meas- 


MIXING  AND  CARE  OF  THE  FOOD   171 

lire  the  sugar  with  the  tablespoon  and  add  to 
the  food.  If  level  tablespoonfuls  are  ordered, 
level  each  with  a  knife,  heaping  tablespoonfuls 
mean  all  you  can  get  upon  the  tablespoon. 
Stir  until  the  sugar  is  dissolved  and  the  food 
is  done.  Using  the  funnel,  pour  into  each 
bottle  the  amount  baby  is  to  have  at  each  feed- 
ing. Stop  up  the  bottles  with  clean  absorbent 
cotton  and  put  the  rack,  full,  in  the  ice  chest, 
directly  on  the  ice  if  possible ;  wash  up  the  uten- 
sils and  put  them  away  for  the  following  day. 

And  now,  when  the  feeding  time  comes,  all  The 
we  have  to  do  is  place  one  of  these  bottles  in  tue™ 
a  pan  of  hot  water,  or  in  an  alcohol  bottle  Food< 
heater,  and  the  milk  is  not  contaminated  by 
handling.     The   food   should   be   just   body 
temperature  when  it  is  fed.     It  is  just  as 
bad  to  have  it  too  hot  as  it  is  to  have  it  too 
cold.     The    temperature    should    be    tested 
by  pouring  a  few  drops  upon  the  forearm  and 
never  by  putting  the  nipple  in  one's  own 
mouth,  or  touching  the  finger  to  the  food  it- 
self.    In  winter  it  is  well  to  have  a  woolen 
bag  or  knitted  cover,  which  just  fits  the  bottle, 
to  hold  the  heat  in  during  the  twenty  min- 
utes while  the  baby  is  feeding. 


172  THE   HEALTHY   BABY 

THE  COMPOSITION  AND  STRENGTH  OP 
THE  FOOD 

A  Radical  THE  days  of  complicated  formulas  for 
from  ow  babies'  foods  are  over.  Well  babies  do  not 
need  top  milks  and  creams,  whey,  limewater, 
and  the  various  foods  that  we  have  formerly 
used.  Such  foods  should  be  reserved  for 
sick  babies  who  are  under  the  physician's 
care.  This  is  a  great  departure  from  the 
methods  that  we  have  used  for  the  last  fif- 
teen or  twenty  years,  but  I  speak  with  the 
authority  of  experience.  Plain  cow's  milk 
(with  its  cream  all  stirred  in)  to  which  is 
added  water  and  sugar,  answers  all  the  re- 
quirements of  a  good  food  until  the  baby  is 
seven  or  eight  months  of  age,  when  barley 
or  oatmeal  gruels  may  be  used  instead  of  the 
water.  Plain  milk  mixed  with  water  is 
easier  to  digest  than  cream  or  top  milks,  and 
nourishes  the  baby  as  well  or  better.  The 
water  is  added  so  that  the  food  will  not  be 
too  concentrated  for  the  digestion,  as  well 
as  to  give  the  proper  amount  of  bulk  and 
furnish  the  required  quantity  of  liquids  that 
the  child  needs  in  twenty-four  hours. 


COMPOSITION   AND   STRENGTH   OF   FOOD       173 

The  sugar  is  added  solely  for  its  nutri-  The  Sugar, 
tional  value  and  for  its  laxative  action  upon 
the  bowels,  and  not  at  all  for  the  taste. 
Sugar  is  very  concentrated  nourishment  and 
is  therefore  one  of  the  most  important  in- 
gredients of  the  food.  One  ounce  of  sugar 
supplies  as  much  nourishment  as  six  ounces  of 
milk.  Sugar  also  is  usually  the  most  diffi- 
cult part  of  the  food  to  digest.  If  too  much 
of  it  is  given,  it  may  cause  either  diarrhea  or 
vomiting ;  while  if  too  little  is  given,  the 
child  will  not  gain  in  weight.  Milk  sugar, 
which  has  been  so  extensively  used  in  the 
past,  should  never  be  used  where  there  is  any 
digestive  disturbance.  It  is  not  as  easily 
digested  as  either  cane  sugar  (ordinary  table 
sugar)  or  malt  sugar.  The  latter  is  the  best 
of  all  the  sugars,  especially  for  young  babies 
and  for  those  with  a  weak  digestion.  The 
malt  sugar  that  I  have  always  used  is  Mead's 
Dextri-Maltose.  It  is  nothing  less  than 
marvelous  to  see  a  baby  (as  I  have  in  in- 
numerable cases)  who  has  never  done  well 
when  fed  on  other  mixtures,  thrive  and  gain 
at  once  on  the  simple  milk  and  water  mixtures 
when  Dextri-Maltose  is  used. 


174  THE   HEALTHY   BABY 

The  important  considerations,  then,  in 
deciding  upon  a  well  baby's  food  are  three- 
fold :  the  amount  of  milk,  the  amount  of 
sugar,  and  the  amount  of  water  to  be  added  to 
make  up  the  proper  bulk  and  concentration. 
The  quantities  of  these  ingredients  depend 
HOW  to  upon  the  baby's  weight  and  age.  The 
?aiproper  amount  of  actual  cow's  milk  a  given  baby  needs 
oTMUk*  in  twenty-four  hours  to  sustain  life  and  make  a 
proper  gain  in  weight  is  twice  the  number  of 
ounces  of  milk  as  he  weighs  in  pounds,  provided 
he  can  digest  one  and  one  half  ounces  of 
sugar  in  his  total  daily  quantity  of  food. 
The  Enough  water  is  added  to  make  the  proper 
of  Water,  amount  of  food  (the  total  quantity  in  twenty- 
four  hours),  which  amount  is  determined, 
of  course,  by  the  quantity  at  each  feeding 
and  the  number  of  feedings  in  twenty-four 
hours.  The  general  rule  for  the  quantity  of 
food  at  each  feeding  is  1  to  1|  ounces  more 
than  the  number  of  months  of  the  baby's 
age ;  at  four  months  give  5  or  5|  ounces  at  a 
feeding;  at  six  months,  7  ounces,  etc.  The  rule 
for  the  number  of  feedings  in  twenty-four 
hours  is  as  follows :  the  first  three  months, 
10  feedings;  the  fourth  month,  8  feedings; 


COMPOSITION   AND    STRENGTH   OF   FOOD      175 

the  fifth  month?  feedings;  after  that,  6  feed- 
ings. To  illustrate  :  a  child  three  months  of 
age  who  weighs  12  pounds  should  receive 
and  digest  24  ounces  of  cow's  milk  in  twenty- 
four  hours.  To  this  must  be  added  the 
proper  amount  of  water  to  make  up  the  bulk, 
and  1|  ounces  of  sugar.  Therefore,  if  this 
baby  were  able  to  take  4|-  ounces  of  food 
every  2£  hours,  —  8  feedings  in  twenty-four 
hours, — he  would  receive  36  ounces  of  food 
in  twenty-four  hours,  24  ounces  of  which 
is  milk,  12  ounces  of  water,  and  1^  ounces 
of  sugar. 

The  table  on  the  opposite  page  gives  an  ap- 
proximate scheme  for  feeding  babies  of  differ- 
ent weights  and  ages.  It  is  not  intended  for 
babies  with  digestive  disturbances,  nor  will  it 
invariably  suit  every  well  baby. 

The  question  of  how  often  a  bottle  baby  is  Number  of 
to  be  fed  is  not  always  an  easy  one  to  decide,  ings  for  ** 
In  general  the  small  baby,  or  one  under  three 
months  of  age,  should  be  fed  every  two  hours 
from  6  A.M.  until  10  P.M.  with  one  feeding  at 
2  A.M.,  making  in  all  ten  feedings  in  twenty- 
four  hours.     At   three   months    (during   the 
fourth  month),  the  baby  may  be  fed  every  two 


TABULATED  SCHEME  FOR  FEEDING 


AGE 

FOOD 

TOTAL 
QUANTITY 
IN  24 
HOURS 

AMOUNT 
AT  EACH 
FEEDING 

INTERVALS 

BETWEEN 

FEEDINGS 

NUMBER 
OF  FEED- 
INGS IN 
24  HOURS 

Oz. 

Oz. 

Hrs. 

1st  week  .    . 

See  "  Food  for  New-born 

10  to  15 

1  to  1J 

2 

10 

Baby,"  p.  178 

2d  week   .     . 

See  "  Food  for  New-born 
Baby,"  p.  178 

20 

2 

2 

10 

Weight 

^ 

1 

a 

(stripped) 

i 

£ 

CO 

Lb. 

Oz. 

Oz. 

Oz. 

3d  and  4th  I 
weeks        j 

6 
7 
8 

12 
14 
16 

13 
11 
9 

1 
1 
1 

(      25 

21 

2 

10 

7 

14 

16 

11 

| 

2d  month 

8 

16 

14 

H 

\      30 

3 

2 

10 

I 

9 

18 

12 

H 

) 

3d  month    •< 

8 
9 
10 

16 
18 
20 

14 
12 
10 

U 
li 
H 

I     30 

3 

2 

10 

4th  month  J 

9 
10 
11 

18 
20 
22 

18 
16 
14 

H 
11 
H 

}-     36 

41 

21 

8 

( 

12 

24 

12 

li 

) 

( 

11 

22 

18 

li 

1 

6th  month  •< 

12 
13 

24 
26 

16 
14 

li 
li 

(•  '40 

5} 

3 

7 

( 

14 

28 

12 

H 

) 

12 

24 

18 

li 

) 

13 
14 

26 

28 

16 
14 

U 
li 

r 

7 

3 

6 

15 

30 

12 

li 

> 

( 

13 

26 

16 

H 

i 

7th  month  J 

14 
15 
16 

28 
30 
30 

14 
12 

12 

H 

li 

r 

7 

3 

6 

14 

28 

20 

li 

15 

30 

18 

H 

16 

32 

16 

H 

8th  month 
to  1st  year 

17 
18 
19 

32 
34 
34 

16 
14 
14 

H 
U 
H 

•      48 

8 

3 

6 

20 

36 

12 

li 

21 

36 

12 

U 

22 

38 

10 

H 

Under  "Interval  between  feedings"  is  meant  from  6  A.M.  to  10  P.M. 
One  night  feeding  at  2  A.M.  is  allowed  until  five  months  of  age. 

Two  level  tablespoonfuls  of  cane  sugar  (leveled  with  a  knife)  make  an  ounce.      Two 
rounding  tablespoonfuls  of  Dextri-Maltose  make  an  ounce. 


COMPOSITION   AND   STRENGTH   OF   FOOD       177 

and  one  half  hours  from  6  A.M.  to  9  P.M., 
with  one  feeding  at  2  A.M.,  giving  eight  feed- 
ings in  twenty-four  hours.  At  four  months 
(during  the  fifth  month),  the  feedings  come 
three  hours  apart  from  6  A.M.  to  9  P.M.,  with 
one  feeding  at  2  A.M.,  making  seven  feedings 
in  twenty-four  hours.  After  five  months 
of  age,  six  feedings  in  twenty-four  hours  are 
sufficient.  In  other  words,  the  night  feeding 
is  omitted  at  five  months,  and  the  baby  is 
fed  every  three  hours  from  6  A.M.  to  9  P.M. 
From  then  on  throughout  the  bottle  period, 
the  number  of  feedings  and  the  intervals 
between  them  remain  unchanged.  However, 
I  have  fed  many  fat,  robust  babies  from  birth 
at  three-hour  intervals  during  the  day  with 
one  feeding  at  2  A.M.,  making  seven  feedings 
in  twenty-four  hours.  These  three-hour  in- 
tervals, of  course,  make  the  care  of  the  baby 
much  easier.  If  the  baby  is  weak  and  under 
weight,  two-hour  intervals  are  advisable  at 
any  age  up  to  six  months,  provided  the  food 
is  of  the  proper  strength. 

As  to  the  quantity  the  baby  shall  get  at  Quantity 
each  feeding,  I  can  only  give  rules  for  the  Feeding. 
well  baby.  Those  who  have  not  been  up  to 


178  THE    HEALTHY   BABY 

the  standard  of  weight  and  development, 
and  those  who  are  actually  sick,  need  expert 
advice,  and  I  would  not  assume  the  respon- 
sibility of  generalizing  for  them.  The  well 
baby  will  take  one  half  to  one  ounce  at  a 
feeding  during  the  first  week.  During  the 
second  week  he  is  usually  able  to  take  care 
of  two  ounces ;  during  the  third  and  fourth 
weeks,  he  may  take  two  and  one  half  ounces; 
and  during  the  second  month,  three  ounces 
at  a  feeding.  After  that,  he  can  take  one 
to  one  and  one  half  ounces  more  than  the  num- 
ber of  months  of  his  age  up  to  eight  ounces. 
It  is  never  necessary  to  give  the  bottle  baby 
more  than  eight  ounces  at  a  feeding.  I  would 
emphasize  the  fact  that  these  rules  apply 
only  to  well  babies  of  normal  weight  and  de- 
velopment for  their  age.  Much  harm  is 
done  by  the  novice  trying  to  feed  sick  babies. 
After  many  years  of  practice,  I  still  feel  that 
the  feeding  of  sick  babies  is  a  matter  of  judg- 
ment based  upon  a  large  experience. 
Food  for  During  the  first  week  a  baby's  digestion 
will  not  stand  enough  food  to  make  him 
gain  and  we  should  not  expect  it  of  the  bottle- 
fed  baby.  Therefore  the  rules  given  above 


COMPOSITION   AND   STRENGTH   OF   FOOD       179 

do  not  apply  to  him.  Occasionally  it  is  neces- 
sary to  feed  a  baby  on  the  bottle  from  the 
start,  through  illness  of  the  mother  or  because 
there  is  absolutely  no  breast  milk.  In  start- 
ing his  food,  make  it  very  weak  at  first  and 
work  up  a  little  each  day,  until  by  the  middle 
or  end  of  the  second  week  the  food  is  strong 
enough  to  make  him  gain.  On  the  second  or 
third  day  make  the  twenty-four-hour  quan- 
tity of  food  with  three  ounces  of  milk  and 
twelve  of  water  (boiled)  —  no  sugar.  The 
next  day  give  him  four  ounces  of  milk,  twelve 
ounces  of  water,  one  teaspoonful  of  sugar; 
the  next  day  five  ounces  of  milk,  twelve 
ounces  of  water;  and  so  on.  Each  day  in- 
crease the  food  by  adding  one  more  ounce  of 
milk  until  by  the  tenth  or  fourteenth  day  the 
baby  is  getting  food  of  the  proper  strength 
for  his  weight.  In  the  meantime  the  sugar 
should  be  gradually  increased  also,  one 
teaspoonful  at  a  time,  until  one  or  one  and 
one  half  ounces  are  given  in  the  total  twenty- 
four-hour  quantity  of  food.  It  is  usually  best 
to  add  one  more  level  teaspoonful  every  other 
day.  For  the  first  few  weeks,  it  is  well  to 
bring  the  milk  and  water  rapidly  to  an  active 


180  THE   HEALTHY   BABY 

boil,  stirring  vigorously  so  that  a  scum  will 
not  form  upon  the  top.  This  boiling  makes 
the  milk  more  digestible,  but  should  not  be 
continued  for  more  than  a  month  or  so.  The 
sugar  is  not  added  until  the  food  is  boiled  and 
taken  off  the  stove. 

Food  for  The  gradual  increasing  of  the  food,  as  de- 
whohave  scribed  in  the  paragraph  above,  also  holds 

D0t  t°eue  &°°d  m  babies  of  any  age  who  are  fed  by  this 
system  of  feeding  for  the  first  time,  or  those 
who  have  not  done  well  on  other  foods,  al- 
though it  is  not  necessary  to  make  the  food 
so  weak  at  the  start  for  older  babies,  and  it 
may  be  increased  more  rapidly.  It  is  usually 
well  to  begin  older  babies  with  one  third 
milk  and  two  thirds  water,  boiled  after  mix- 
ing. No  sugar  is  added  to  the  food  until  the 
stools  appear  well  digested  and- vomiting  has 
ceased  or  improved  greatly.  When  the  baby's 
digestion  improves,  as  shown  by  the  vomit- 
ing and  stools,  the  strength  of  the  milk  should 
be  increased  by  adding  one  or  two  ounces 
more  of  milk,  and  one  or  two  ounces  less  of 
water  each  day,  until  he  is  getting  milk  of 
the  proper  strength  for  his  age  and  weight. 
The  sugar  is  also  begun  at  the  same  time, 


COMPOSITION   AND    STRENGTH   OF   FOOD      181 

adding  at  first  only  one  teaspoonful  and  in- 
creasing it  each  day,  a  teaspoonful  or  two  at  a 
time,  until  one  and  one  half  ounces  are  given 
in  the  total  twenty-four-hour  amount.  Re-  • 
:.. ember  a  child  may  not  gain  who  is  overfed. 
He  is  also  apt  to  have  diarrhea  and  vomiting. 
Remember,  also,  that  sugar  will  cause  diarrhea, 
undigested  stools,  or  vomiting,  and  that  some 
babies  will  stand  more  of  it  than  others. 
That  is  why  it  is  best  to  stop  all  sugar  tem- 
porarily when  these  symptoms  appear.  The 
food  should  be  boiled  also,  as  described  in  the 
paragraph  above. 

Proprietary  or  patent  foods  are  not  neces-  Patent 
sary  for  any  baby.  I  believe  that  there  is  necessary!" 
no  virtue  in  the  foods  themselves,  and  any 
babies  that  I  have  ever  seen  who  have  done 
well  on  the  proprietary  foods  have  done  so  on 
account  of  the  sugar  or  carbohydrate  in  the 
food  and  on  account  of  the  cow's  milk  which 
the  mother  adds  to  it.  There  is  no  myste- 
rious lifegiving  property  about  them.  Most 
of  them  are  made  up  of  starches  and  the 
various  kinds  of  sugars  and  some  of  them  have 
dried  milk  or  egg  added. 


182  THE    HEALTHY   BABY 

FOOD   FOR  TRAVELING 

BABIED  really  should  not  travel  at  all,  but 
they  often  have  to.  However,  the  necessity 
should  be  very  great  to  take  a  bottle-fed 

• 

child  on  a  long  journey,  especially  if  he  has 
had  any  difficulty  with  his  feedings.  Each 
spring,  particularly,  I  am  busy  instructing 
mothers  how  to  prepare  the  food  for  a 
longer  or  shorter  journey.  If  it  is  practicable, 
a  traveling  ice  box  with  a  wicker  cover 
may  be  carried  and  good  milk  carefully 
prepared  will  last  forty-eight  hours  in  this, 
the  ice  being  replenished  constantly.  Where 
this  is  not  advisable,  the  food,  after  it  is 
made,  but  before  the  sugar  is  added,  is  boiled 
for  at  least  ten  minutes.  It  is  then  put  into 
preserving  jars  which  have  been  boiled  with 
the  cover  and  rubber,  and  which  are  still 
piping  hot  when  the  boiling  food  is  added, 
and  the  jars  are  sealed.  This  will  last  forty- 
eight  hours,  if  cooled  immediately  and  kept 
cold  throughout  the  journey.  The  Walker- 
Gordon  Milk  Laboratories  make  a  specialty 
of  putting  up  milk  for  traveling.  The 
milk  is  prepared  all  ready  for  the  baby  to  take 


DIET  AFTER   THE    FIRST   YEAR  183 

in  any  strength  or  combination  desired,  and 
will  last  throughout  a  journey  of  six  or  seven 
days. 

For  any  prolonged  journey  where  fresh 
milk  cannot  be  procured,  unsweetened  con- 
densed milk  is  the  best  food.  Remember  that 
condensed  milk  is  only  twice  as  strong  as 
fresh  cow's  milk  and  therefore  make  the  food 
up  accordingly,  adding  the  proper  amount 
of  sugar  and  water.  Remember,  also,  that 
it  will  not  keep  much  longer  than  fresh 
milk  once  the  can  is  opened.  When  it  is 
given  over  any  extended  period  of  time,  give 
the  baby  orange  juice  each  day  to  add  the 
fresh  element  to  his  diet.  Condensed  milk 
is  not  a  good  diet  for  a  baby,  and  I  would 
not  put  myself  on  record  as  indorsing  it, 
but  there  are  occasions  when  it  is  useful, 
and  this  is  one  of  them. 

DIET  AFTER  THE   FIRST  YEAR 

THE  second  year  is  the  most  difficult  feed-  Three 
ing  period  of  childhood.     All  children  in  their  children. 
second  year  may  be  divided  into  three  classes  : 
Those  who  won't  eat  anything;    thos^who 
eat  everything  they  shouldn't ;  and  those  who 


184  THE    HEALTHY   BABY 

have  their  diet  regulated  for  them  at  the  cost 

of  much  patience,  care,  and  thought  on  the 

mother's    part.     It    is    for    you   to   choose 

under  which  class  your  baby  will  come,  for 

it  is  within  your  power  to  regulate  his  diet 

and  lead  him  toward  a  life  of  bodily  health 

and  happiness.     Help  him  to  form  a  taste 

for  the  proper  kind  of  food  and  he  will  enjoy 

eating  things  that  are  good  for  him  as  much 

as  he  will  those  that  are  injurious. 

DO  not      A  child  that  does  not  want  to  eat  solid  food 

CMWwith  at  this  aSe  is  generally  overfed  with  milk, 

Things  he  or  pernaps  he  is  allowed  to  nibble  on  crackers, 

should  not 

Eat.  or  bread,  or  cake  all  day  long,  or  perhaps  have 
a  drink  of  milk  whenever  he  is  thirsty.  Eat- 
ing between  meals  is  not  permissible.  A 
child  who  eats  things  he  shouldn't  is  taught  to 
do  so  by  giving  him  a  taste  of  this  or  a  taste 
of  that  from  the  table  where  he  is  allowed  to 
eat  with  the  family.  I  think  it  is  only  fair 
to  the  child  not  to  set  before  him  things  which 
he  is  not  allowed  to  eat.  If  he  comes  to  the 
table  with  the  adults,  they  should  themselves 
forego  some  of  the  pleasures  of  the  palate. 
A  good  compromise  is  to  allow  the  child  to 
come  to  the  table  for  breakfast  and  luncheon, 


DIET   AFTER   THE    FIRST   YEAR  185 

which  may  be  simple  meals  such  as  he  can 
eat,  and  to  give  him  his  supper  by  himself 
at  5  or  5.30  o'clock. 

After  the  first  year,  we  may  divide  the  The 
feeding  of  children  into  two  periods,  which,  of 
course,  gradually  merge  one  into  the  other. 
These  are  the  weaning  period,  from  nine  or 
ten  months  to  eighteen  or  twenty  months; 
and  the  period  of  from  eighteen  months  to 
two  years,  when  three  meals  a  day  are  suffi- 
cient. The  weaning  period  begins  when  we 
first  begin  to  feed  baby  from  a  cup  or  spoon 
in  order  to  teach  him  to  eat,  and  it  lasts  until 
he  has  all  his  teeth,  which  is  usually  at  eight- 
een months.  At  nine  or  ten  months  baby  The  Baby 
is  given  a  drink  of  milk  from  the  cup  once  a 
day  before  a  nursing.  A  little  later  we  try 
a  well-cooked  cereal  with  some  milk  upon  it, 
but  no  sugar,  just  to  teach  him  to  eat  cereals. 
Still  later  we  vary  his  training  by  giving  him 
a  piece  of  dry  bread  crust  or  crackers  or  zwie- 
back, just  before  a  nursing  time,  so  he  may 
learn  to  eat  solids.  It  is  very  important  that 
the  child  should  learn  to  drink  milk  at  this 
time,  because  if  he  does  not  he  may  dislike 
it  all  his  life.  It  should  be  offered  to  him 


186  THE    HEALTHY  BABY 

day  after  day  until  he  has  acquired  a  taste 
for  it.. 

When  introducing  a  new  food  into  the  diet, 
begin  with  very  small  quantities,  just  a  taste 
at  first  and  gradually  increase  the  amount. 
If  any  new  article  of  diet  seems  to  disagree,  it 
is  usually  well  to  persist  in  giving  it  in  small 
amounts.  It  is  well  to  remember  that  the 
stools  are  colored  at  times  by  the  vegetables 
that  are  given.  For  instance,  it  is  not  at  all 
uncommon  to  see  the  green  spinach  in  the 
stools  nor  the  yellow  of  carrots.  This  is 
no  contraindication  to  giving  these  vege- 
tables. 

Diet  One  By  the  time  he  is  a  year  old  he  has  per- 
Fourteen  fected  himself  enough  in  the  art  of  eating  to 
Months,  enable  nim  to  get  a  wnoie  meal  without  the 


aid  of  the  bottle  or  breast,  which  meal  con- 
sists of  a  cereal  and  drink  of  milk  from  the  cup 
with  a  piece  of  hard  bread  in  his  hand  to 
chew  upon.  He  is  at  this  time  fed  every 
three  hours  from  6  A.M.  to  9  P.M.,  and  there- 
fore gets  five  bottles  or  breast  feedings  in 
twenty-four  hours  and  one  meal,  as  above 
described.  It  does  not  make  any  particular 
difference  what  time  this  meal  comes,  but 


DIET  AFTER   THE    FIRST  YEAR  187 

it    usually    takes    the    place    of    either    the 
9  o'clock  or  12  o'clock  bottle. 

At  fourteen  months  he  can  get  two  meals  a  Diet  at 
day  in  addition  to  the  three  feedings  from  the  Months!1 
bottle,  cup,  or  breast.     The  schedule  for  the 
day  is  as  follows  :  — 

7  A.M.,  cereal,  milk,  toast. 

11  A.M.,  eight  ounces  of  undiluted  milk 
from  the  bottle  or  cup,  or  a  breast  feeding. 

2  P.M.,  baked  potato  with  butter  or  milk 
upon  it,  a  cup  of  milk,  bread. 

6  P.M.,  eight  ounces  of  undiluted  milk  from 
the  bottle  or  cup,  or  a  breast  feeding. 

10  P.M.,  eight  ounces  of  undiluted  milk  from 
the  bottle  or  cup,  or  a  breast  feeding. 

Rarely  at  this  age,  does  the  breast  furnish 
milk  in  the  proper  quality  and  quantity  for 
the  feedings  given  at  11  A.M.  and  6  and  10 
P.M.  If  the  breast  milk  supply  is  good, 
these  three  feedings  may  be  given  from  the 
breast;  otherwise,  milk  from  the  cup  takes 
its  place. 

At  fifteen  months  we  give  a  meal  made  up  Diet 
of  one  vegetable,  mashed  fine,  besides  the  Eighteen* 
baked  potato.     The  vegetables  contain  iron,  Months- 
which  baby  needs  very  much  at  this  age.     We 


188  THE   HEALTHY 

> 

also  introduce  eggs  into  his  diet.  He  is  now, 
at  fifteen  months,  getting  four  feedings  in 
twenty-four  hours,  three  of  which  he  may 
take  at  the  family  mealtimes,  with  eight  ounces 
of  undiluted  milk  at  10  P.M.  His  schedule 
for  the  day  is  then  as  follows  :  - 

7   or   8   A.M.      Breakfast:    cereal,    bread, 
cup  of  milk. 

12   or   1    P.M.     Dinner:    an   egg,   potato, 
one  other  vegetable,  bread,  dessert  of  fruit. 

5  or  6  P.M.     Supper :  milk,  bread. 

10  P.M.     Eight  ounces  of  undiluted  milk 
from  the  bottle  or  cup. 

Raw  fruits  in  the  middle  of  the  morning 
and  afternoon  help  to  shorten  the  intervals 
between  meals  when  the  child  is  unaccustomed 
to  going  so  long  without  eating.     He  may 
have  a  scraped  raw  apple,  an  orange,  pear, 
or  peach  between  any  or  all  of  his  feedings, 
according  to  the  condition  of  the  bowels. 
Diet      At  eighteen  months  of  age  all  the  teeth 
M?nthseto  nave  come  through  and  meat  is  added  to  the 
TWO  Years,  dietary.     Occasionally  it  is  a  little  later  than 
eighteen  months,  but  I  am  generalizing.     And 
now  three  meals  a  day  are  all  that  are  nec- 
essary since  the  meat  supplies  more  concen- 


DIET  AFTER   THE    FIRST   YEAR  189 

trated  nourishment,  and  the  10  P.M.  feeding 
is  omitted.     The  menu  for  the  day  is  :  — 

7  or  8  A.M.  Breakfast:  cereal,  egg, 
bread  or  toast. 

12  or  1  P.M.  Dinner:  meat,  potatoes, 
one  vegetable,  dessert  of  cut  fruit  or  sponge 
cake. 

5  or  6  P.M.  Supper:  bread  toasted  hard 
in  the  oven,  cup  of  milk,  or,  instead  of  the 
milk,  fruits  cut  up  raw  or  cooked,  or  plain 
broth  may  be  given  with  the  bread. 

The  supper  is  usually  the  milk  meal,  but 
it  may  be  varied  occasionally  for  the  sake  of 
eliminating  monotony.  Some  children  never 
tire  of  the  milk  at  this  meal,  so  that  it  is  not 
necessary  to  make  this  change.  The  milk 
should  be  given  at  least  five  or  six  times  a 
week. 

There  is  really  no  reason  why  a  child  should  Diet  for 
have  a  diet  that  differs  from  the  one  that  I  children, 
have  given  until  he  reaches  adult  life,  with  the 
exception  of  desserts,  which  I  will  mention 
later.     This  diet  really  contains  all  the  neces- 
sary kinds  of  food,  and  allows  considerable 
latitude,  so  that  it  is  really  sufficient,  as  far 
as  that  is  concerned,  for  the  adult.     It  should 


190  THE    HEALTHY   BABY 

not  differ  from  this  one  under  any  circum- 
stances, until  the  school  age  is  reached. 
When  the  child  starts  going  to  school,  how- 
ever, it  may  not  be  practicable  to  continue 
with  the  hearty  meal  at  noon  and  the  light 
supper.  At  the  same  time  I  believe  that  this 
is  still  the  best  plan  if  it  is  possible  to  carry 
it  out.  When  the  hearty  meal  must  be  given 
at  night,  the  child  should  not  go  to  bed  for  at 
least  two  hours  afterward.  It  is  also  im- 
portant that  meat  should  not  be  given  more 
than  once  a  day  until  after  the  tenth  or  twelfth 
year.  This  makes  the  noon  meal  rather  a 
slim  one  unless  special  care  is  given  to  it. 
Milk,  custards,  junkets,  and  hearty  desserts 
made  with  milk  and  eggs  often  help  to  make 
the  luncheon  a  nourishing  one,  so  that  the 
active  child  shall  not  go  from  early  morning 
until  a  late  dinner  without  sufficient  nour- 
ishment. 

Kinds  of  Bread  should  never  be  given  when  it  is 
BreGivl0  fresh  or  soft-  It;  should  be  stale  enough  to 
crumble.  It  is  best  cut  in  squares  and  put 
into  the  oven  until  it  is  brown  and  hard  all  the 
way  through.  Do  not  give  it  this  way  all 
the  time,  for  the  monotony  soon  sickens  the 


DIET   AFTER   THE    FIRST   YEAR  191 

child  of  it.  Vary  the  kinds  of  bread  with 
white  bread,  whole  wheat  bread,  graham 
bread,  rye  bread,  and  bran  biscuits.  Crack- 
ers are  also  a  good  addition  to  the  starchy 
foods.  Hard-tack,  soda  crackers,  oatmeal 
crackers,  graham  crackers,  egg  biscuit,  rice 
and  arrowroot  wafers,  with  an  occasional 
sweetened  cracker  for  dessert  at  supper,  are 
allowable.  Never  give  hot  bread,  hot  muffins, 
doughnuts,  griddlecakes,  or  waffles. 

Cereals  are  good  for  the  child,  but  one  cereal  The  Place 
meal  a  day  is  enough,  and  that  is  best  at  in  the  Diet 
breakfast.  Cereals  may  be  cooked  in  milk  or 
water.  They  should  always  be  well  cooked ; 
one  to  three  hours,  according  to  the  coarse- 
ness of  the  grain.  Undercooked  cereals  are 
the  source  of  much  stomach  disturbance.  It 
is  therefore  well  to  cook  them  the  night  be- 
fore, as  they  are  apt  to  be  underdone  when 
hastily  cooked  for  breakfast.  Cream  of 
wheat,  rolled  oats,  wheatina,  farina,  gritz, 
cornmeal  mush,  rice  and  hominy,  are  all 
healthful.  Teach  the  child  to  eat  them 
without  sugar,  but  with  plenty  of  milk  and 
some  cream,  and  he  will  like  them  just  as 
well  as  though  they  were  sweetened.  In. the 


192  THE    HEALTHY   BABY 

first  place,  sweetened  food  at  the  morning 
meal  is  apt  to  take  away  the  appetite  for  the 
rest  of  the  meal,  and  in  the  second  place  it  is 
well  to  teach  the  child  to  like  the  cereals  for 
their  own  taste.  The  so-called  ready  cooked 
cereals  should  be  reserved  for  children  over 
two  years  of  age. 

Vegetables  Vegetables  are  a  necessity  in  the  diet  be- 
BNecessary  cause  of  the  fresh  element  they  supply  and 
iron.  on  account  of  the  iron  they  contain.  Babies 
are  born  with  enough  iron  stored  in  the  liver 
to  last  them  during  the  first  year,  for  a  mini- 
mum amount  is  supplied  in  the  breast  milk 
and  cow's  milk.  So  we  begin  early  with  the 
vegetables.  Potatoes  must  be  well  cooked, 
either  boiled,  baked,  or  mashed,  but  never 
fried  or  scalloped.  One  other  vegetable 
once  each  day  at  the  hearty  midday  meal 
must  be  prepared.  Peas,  string  beans,  spin- 
ach, carrots,  asparagus  tips,  beets,  well- 
cooked  winter  squash,  and  boiled  parsnips, 
are  all  suitable  vegetables.  Children  should 
not  be  allowed  cabbage,  cauliflower,  onions, 
shelled  beans,  tomatoes,  lettuce,  celery,  tur- 
nips, or  sweet  potatoes  until  after  the  third  or 
fourth  year.  The  vegetables  should  always 


DIET   AFTER   THE    FIRST   YEAR  193 

be  cooked  until  they  are  soft,  and  mashed  fine 
with  a  fork. 

Meat  is  given  sparingly  at  first.  A  table-  what 
spoonful  of  rare  beef  scraped  with  a  fork  is  give  and 
thoroughly  mixed  into  the  potato  for  the  cook  them, 
first  week  or  two,  after  the  eighteenth  month. 
The  quantity  is  gradually  increased  and  the 
variety  extended  during  the  next  month  or 
two.  The  meat  should  always  be  cooked 
rare  and  not  boiled,  except  chicken.  It 
should  be  cut  up  very  fine  and  mixed  with  the 
potato  during  the  second  and  third  years. 
The  meats  a  child  may  eat  are  :  beef — roast, 
broiled,  or  chopped  Hamburger  fashion ;  lamb 
— roast  or  chops  ;  chicken — roast,  broiled,  or 
boiled;  veal  —  roast  or  broiled ;  fish — boiled; 
bacon — cooked  dry  and  eaten  in  the  fingers 
at  two  and  one  half  years.  Never  give  pork, 
ham,  sausage,  liver,  tripe,  or  thickened  gravies. 

Eggs  should  be  given  boiled,  coddled,  Eggs, 
dropped  in  water,  and,  after  two  and  one  half 
years,  hard  boiled.  The  whites  should  be  soft 
and  jellylike  instead  of  tough  and  leathery. 
In  order  to  do  this,  put  them  into  cold 
water,  and  place  them  upon  the  stove  until 
the  water  comes  to  a  boil,  and  then  set  them 
o 


194  THE   HEALTHY   BABY 

aside  in  the  water  for  a  few  minutes.  It  some- 
times takes  many  trials  to  get  them  just  right, 
but  a  little  practice  soon  teaches  the  beginner. 
Eggs  should  never  be  fried.  Many  mothers 
think  their  children  cannot  eat  eggs,  but  this 
is  rarely  true.  If  the  egg  is  not  well  borne, 
give  a  teaspoonful  each  morning  until  that 
much  is  well  taken  and  gradually  increase 
to  larger  amounts. 

Soups  not  Soups  I  have  not  said  very  much  about 
because  I  do  not  believe  they  are  an  impor- 
tant article  of  food.  Thickened  meat  soups 
are  indigestible.  Clear  broths  and  beef  tea 
are  mostly  water  and  are  given  only  to  vary 
the  diet,  stimulate  the  appetite,  and  act  as  a 
vehicle  in  which  bread  and  crackers  may  be 
eaten. 

simple       Desserts  are  not  given  until  the  second  year. 
-  Then  they  should  be  simple  puddings  sweet- 


mended.  ene^?  such  as,  bread  pudding,  rice  pudding, 
blancmange,  gelatine  puddings,  farina,  ice 
cream,  soft  and  hard  custards,  sponge  cake 
and  lady  fingers  dry  or  with  whipped  cream, 
angel  cake,  sweetened  crackers,  and  fruits 
raw  or  cooked.  No  other  cake  or  pastry  is 
allowed  until  after  the  child  is  twelve  years 


DIET    AFTER    THE    FIRST    YEAR  195 

old.  Butter,  lard,  or  suet  cooked  into  any 
food  is  indigestible,  and  that  is  why  the  usual 
pastry,  rich  cake,  and  cookies  are  ruinous  to 
the  digestion. 

Children  seem  to  crave  sweets,  but  I  am  Craving 
not  one  of  those  who  believe  that  this  craving  not  Normal 
is  normal  and  should  be  catered  to.  I  do 
know,  however,  that  from  a  practical  stand- 
point more  indigestion  and  ill  health  is  caused 
among  children  by  eating  sweets  than  by  any 
other  one  article  of  diet.  A  moderate  amount 
of  candy  usually  does  ,10  harm,  but  modera- 
tion is  difficult  to  achieve.  Friends  and  rela- 
tives always  see  to  it  that  the  supply  is  not 
lacking,  and  it  is  far  easier  to  lay  down  rules 
than  it  is  to  carry  them  out.  Candy  may, 
however,  be  allowed  after  the  second  year, 
once  or  twice  a  week,  one  or  two  pieces  after 
dinner,  provided  the  dessert  has  not  been  a 
sweet  one.  Sugar  takes  away  the  appetite 
because  it  is  a  very  concentrated  form  of 
nourishment.  For  the  same  reason  it  harms 
the  digestion.  Children  who  have  poor  appe- 
tites should  have  no  sweets  nor  desserts 
whatever. 

Cut  fruits,  berries  of  all  kinds  either  cooked 


196  THE    HEALTHY   BABY 

The  Eating  or  uncooked,  make  good  desserts.  Bananas 
are  the  only  fruit  I  exclude  from  the  dietary. 
Under  two  years  fruits,  such  as  apples,  pears, 
and  peaches,  should  be  scraped  with  a  spoon. 
Berries  should  not  be  allowed,  until  the  latter 
part  of  the  second  year.  It  is  a  false  idea 
that  children  will  not  digest  uncooked  fruits. 
If  they  are  carefully  given  and  not  swallowed 
in  great  pieces  which  have  not  been  mashed 
.  or  scraped,  or  well  masticated,  they  are  as 
digestible  as  cooked  fruits.  Cooked  fruits 
must  not  be  sweeter,  d  too  much.  If  they 
are  made  sirupy  with  a  lot  of  sugar,  they  are 
far  worse  than  when  given  raw.  The  eating 
of  fruits  between  the  meals  helps  the  bowels 
if  the  latter  are  inclined  to  be  constipated. 
It  also  puts  something  into  the  stomach  while 
the  child  is  becoming  accustomed  to  longer 
intervals  between  feedings.  Once  the  taste 
for  fruit  is  acquired,  a  child  is  just  as  well 
pleased  with  it  as  with  cake  and  candy,  and 
it  does  him  no  harm.  For  this  reason  I 
encourage  the  eating  of  fruits  as  much  as 
possible.  Oranges  are  best  eaten  with  the 
spoon  until  the  third  year,  so  that  the  tough- 
est part  of  the  pulp  will  not  be  swallowed. 


DIET   FOR   SICK   CHILDREN  197 

Cut  the  orange  in  half  and  dig  out  the  soft 
part  as  well  as  the  juice.  An  apple  can  be 
most  easily  scraped  if  it  is  cut  in  half  with  the 
skin  on,  and  the  core  dug  out  with  a  spoon. 
The  skin  then  makes  a  cup  out  of  which  the 
rest  of  the  apple  is  scraped  so  that  there  are 
no  hard  pieces  whatever. 

DIET   FOR  SICK  CHILDREN 

As  a  rule  I  do  not  believe  that  sick  children 
ought  to  be  made  to  eat  things  that  are  dis- 
tasteful to  them.  It  is  no  time  to  teach  the 
child  to  cultivate  a  taste  for  any  article  of 
food,  when  he  is  ill.  Another  mistake  that  is 
often  made,  is  to  try  to  force  sick  children 
to  eat.  Occasionally,  especially  during  a  pro- 
longed illness,  this  is  necessary,  but  as  a  rule 
it  is  not.  Still  another  error  that  is  apt  to 
occur,  is  in  allowing  the  child  to  drink  large 
quantities  of  milk  at  irregular  intervals 
during  the  illness.  Especially  if  there  is  any 
fever,  the  thirst  is  apt  to  be  excessive  and 
milk  is  taken  in  place  of  water  to  quench 
the  thirst.  It  is  a  very  good  idea  to  stop  the 
food  altogether  at  the  beginning  of  almost 
any  sickness,  especially  where  there  is  fever. 


198  THE    HEALTHY   BABY 

Broths.  Broths  and  soups  are  very  good  invalid's 
foods,  but  it  must  be  remembered  that,  even 
when  well  made,  they  do  not  contain  a  great 
deal  of  nourishment.  This  may  be  a  dis- 
tinct advantage  where  it  is  advisable  to  avoid 
overtaxing  the  digestion.  Beef,  lamb,  and 
chicken  may  be  used.  The  meat  is  chopped 
up  and  allowed  to  stand  in  cold  water  for  an 
hour  or  two,  when  it  is  put  upon  the  stove 
and  brought  to  a  simmering  heat  of  160°  F., 
but  never  allowed  to  boil.  After  simmering 
in  this  manner  for  two  or  three  hours,  it 
should  then  be  strained  and  set  away  to  cool, 
so  that  the  fat  may  harden  upon  the  top,  in 
order  to  get  every  particle  of  it  off.  It  is 
absolutely  impossible  to  get  the  grease  off 
while  the  soup  is  hot.  Bouillon  capsules 
may  be  temporarily  used  to  make  the  broth, 
where  it  is  our  purpose  to  give  a  weak  food. 

Gruels.  Gruels  help  to  take  the  place  of  milk,  and 
are  often  more  easily  digested  than  milk. 
Especially  during  attacks  of  diarrhea,  the 
gruels  must  be  relied  upon  almost  entirely  for 
nourishment.  When  this  is  the  case,  it  is 
best  to  vary  the  kinds  of  gruels,  so  that  the 
child  will  not  sicken  of  them.  They  should 


DIET   FOR   SICK   CHILDREN  199 

be  made  with  water  only,  adding  a  little  salt, 
but  no  sugar  unless  otherwise  directed  by  the 
physician.  Occasionally,  however,  they  may 
be  made  with  half  milk  and  half  water,  if  it 
is  so  ordered.  The  one  essential  point  is 
to  cook  them  long  enough.  If  made  of  the 
different  flours,  they  should  be  first  mixed 
up  to  a  thin  paste  with  cold  water,  and  the 
paste  stirred  into  the  proper  amount  of  boil- 
ing water  to  which  the  salt  has  been  added, 
and  stirring  vigorously  until  brought  to  an 
active  boil.  They  should  then  be  put  upon 
the  back  of  the  stove,  and  allowed  to  boil 
gently  for  at  least  one  half  hour.  Where 
the  double  boiler  is  used,  gruels  should  be 
cooked  for  at  least  two  hours.  As  a  rule  I 
do  not  approve  of  the  double  boiler,  because 
this  long  cooking  is  apt  to  be  neglected.  I 
may  mention  as  the  different  kinds  of  gruels : 
barley  gruel,  farina  gruel,  arrowroot  gruel, 
cornstarch  gruel,  wheat  flour  gruel,  cracker 
gruel,  browned  flour  gruel,  rice  flour  gruel, 
cornmeal  gruel,  and  oatmeal  gruel.  The 
browned  flour  gruel  is  made  by  putting  ordi- 
nary wheat  flour  into  the  oven  and  leaving  it 
until  it  is  browned  all  through,  stirring  it 


200  THE   HEALTHY   BABY 

occasionally  so  that  it  will  not  burn.  The 
browned  flour  is  then  made  into  a  gruel. 
Oatmeal  and  cornmeal  gruels  should  not  be 
used  in  cases  of  diarrhea.  Any  of  these 
gruels  may  be  dextrinized  or  partially  di- 
gested by  adding  a  teaspoonful  of  Cereo  to 
them  after  they  are  cool  enough  to  taste. 
Dextrinized  gruels  are  often  well  borne  when 
other  foods  are  rejected. 
Bread  Bread  pap  adds  another  variation  to  the 

Pap 

sick  child's  diet.  This  is  made  by  cutting 
thin  slices  of  white  bread  and  putting  them 
into  the  oven  until  they  are  thoroughly 
browned  through.  They  are  then  put  into 
a  saucepan  and  moistened  with  enough 
water  to  make  a  thick  pap,  thoroughly  mixed 
up  and  put  upon  the  stove  and  brought  to 
a  boil.  Neither  sugar  nor  milk  should  be 
added  unless  specially  ordered. 
Junket.  Junket  often  takes  the  place  of  a  more 
solid  food,  especially  for  older  children.  It 
is  also  more  digestible  than  milk.  It  is  made 
in  the  following  manner :  Put  into  a  clean 
saucepan,  one  half  pint  of  fresh  milk,  heat 
lukewarm,  and  then  add  one  teaspoonful  of 
essence  of  pepsin,  or  a  junket  tablet  dis- 


WATER  201 

solved  in  a  tablespoonful  of  cold  water. 
(The  junket  tablets  may  be  bought  at  any 
grocery  store.)  Stir  it  just  enough  to  mix 
the  tablet  with  the  milk,  then  pour  it  into 
small  cups  and  allow  it  to  stand  until  it  is 
firmly  jellied.  A  little  flavoring  may  be 
added,  or  often  a  small  amount  of  sugar, 
while  the  milk  is  heating.  Egg  junket  may 
be  made  by  stirring  in  with  the  milk  a 
thoroughly  beaten  egg.  These  eggs  add  a 
greater  nutrition  value  to  the  food. 

WATER 

STRANGE  as  it  may  seem,  the  giving  of  Water 

,  .  ,    more 

water  to  a  baby  is  an  important  subject  and  harmful 
one  upon  which  there  have  been  many  false 
ideas  in  the  past.  In  some  of  the  leading 
obstetrical  hospitals  of  the  world  it  is  the 
custom  to  administer  sweetened  water  to 
the  new-born  babe  soon  after  he  is  born. 
This  has  been  done  for  two  reasons :  first, 
to  give  the  baby  some  liquid  to  prevent  loss 
in  weight  during  the  first  two  or  three  days 
when  he  is  not  getting  much  nourishment 
from  the  breast ;  and  second,  for  the  laxative 
action  of  the  sugar  upon  the  bowels.  Now 


202  THE   HEALTHY   BABY 

the  reasons  that  this  procedure  is  not  neces- 
sary are  also  twofold :  first,  it  does  not  pre- 
vent the  loss  of  weight;  and  second,  the  new- 
born babe  never  has  any  trouble  in  having 
the  bowels  move  if  he  is  let  alone.  On  the 
other  hand,  the  harm  it  does  is  to  satisfy  the 
baby  so  he  will  not  take  the  breast  well,  his 
stomach  being  filled  with  sweetened  water. 
When  The  small  amount  of  sugar  water  the 
may^be  baby  gets  from  the  breast  is  sufficient  until 
Given.  ne  j^g  learned  to  nurse  vigorously.  Then, 
if  he  cries  a  good  deal,  he  may  be  given  a 
small  amount  of  unsweetened  water.  If  he 
does  not  cry,  give  him  nothing  except  what 
he  gets  from  the  breast.  After  the  flow  of 
milk  has  set  in,  he  will  get  sufficient  water 
in  the  milk  itself  if  the  milk  supply  is  right. 
As  for  the  bottle  baby,  can  you  imagine  a 
more  foolish  procedure  than  giving  him  a 
few  teaspoonfuls  of  water  when  he  is  already 
getting  a  food  which  is  90  per  cent  water? 
A  child  who  is  getting  a  quart  of  liquids  in 
twenty-four  hours  has  far  more  water  in  pro- 
portion to  his  weight  than  does  the  adult. 
Water  for  But  there  comes  a  time  when  it  is  well  to 
children'  &ve  the  baby  water  as  a  matter  of  education, 


WATER  203 

so  that  he  may  learn  to  take  things  from  the 
cup  and  spoon.  At  six  months  it  is  time  to 
begin  this  training  with  a  few  teaspoonfuls. 
In  this  way  gradually  the  baby  learns  to  take  a 
considerable  quantity  so  that  he  is  not  a  stran- 
ger to  swallowing  by  any  other  method  than 
sucking.  The  weaning  is  thus  made  easier. 
After  eighteen  months,  the  child  is  put 
upon  a  drier  diet.  He  is  usually  thirsty  and 
drinks  a  good  deal  of  water  of  his  own  accord. 
If  he  does  not,  it  should  be  offered  to  him  at 
intervals  throughout  the  day. 


PART  VI 
LISTS  AND  TABLES 


LIST  FOR  EXPECTANT  MOTHER 

A  fountain  syringe. 

A  bed-pan. 

One  or  two  enameled  hand  basins. 

New  rubber  cloth,  one  and  a  half  yards  wide,  two 

yards  long,  to  protect  mattress. 
Pilch  cloth,  five  yards  (for  bed  pads). 
Unbleached  muslin,  two  yards  long,  eighteen  inches 

wide  (for  mother's  binders). 
Plenty  of  towels. 

Absorbent  cotton,  one  pound  package. 
Braided  silk  (for  tying  the  cord). 
Large  safety  pins  (two  dozen) . 
Fluid  extract  of  ergot,  one  ounce  (bought  one  week 

before  confinement). 
Brandy,  two  ounces. 

Antiseptic  tablets  (corrosive  sublimate),  one  bottle. 
Boric  acid,  powdered. 
Sterile  gauze  (1  five-yard  package). 


FOR  THE  BABY'S  BASKET 

One  pound  of  absorbent  cotton. 

Safety  pins  of  assorted  sizes. 

A  soft  baby's  hair  brush. 

A  powder  box  containing  powder  and  puff. 

Soap  and  soap  box. 

One  fourth  of  a  pound  of  boracic  acid. 

An  old  soft  blanket  in  which  to  receive  the  child  after 

birth. 

A  couple  of  soft  towels. 
A  bath  thermometer. 
Scales. 

207 


208 


THE    HEALTHY    BABY 


CLOTHES 

Flannel  bands 4 

Knitted  bands 4 

Diapers 4  dozen  or  more 

Shirts 6 

Petticoats,  flannel 4 

Petticoats,  cotton 4 

Slips     . 6 

Socks 6  pairs 

Nightgowns 6 

Jackets 2 

Cloak 1 

Hood 1 

Mittens 1  pair 

Veil 1 

Blankets    .  2 


TABLE  OF  HEIGHT 


AGE 

1  month 

2  months 

3  months 

4  months 

5  months 

6  months 

7  months 

8  months 

9  months 

10  months 

11  months 

1  year 

2  years 

3  years 

4  years 

5  years 

6  years 

7  years 

8  years 


HEIGHT 
20f inches 

21  inches 

22  inches 

23  inches 
23£  inches 

24  inches 
24| inches 

25  inches 
25| inches 

26  inches 
26£  inches 

27  inches 
31  inches 
35  inches 
37| inches 
40  inches 
43  inches 
45  inches 
47  inches 


LISTS   AND   TABLES  209 

TABLE  OF  WEIGHT 

AGE  WEIGHT 

1  month  9    pounds 

2  months  10£  pounds 

3  months  12    pounds 

4  months  13|  pounds 

5  months  15    pounds 

6  months  16    pounds 

7  months  17    pounds 

8  months  18    pounds 

9  months  19    pounds 

10  months  20    pounds 

11  months  20|  pounds 

1  year  21  pounds 

2  years  27  pounds 

3  years  32  pounds 

4  years  36  pounds 

5  years  40  pounds 

6  years  44  pounds 

7  years  48  pounds 

8  years  53  pounds 

NUMBER  OF  PULSE  BEATS  PER  MINUTE 

At  birth 130  to  150 

First  month 120  to  140 

1  to  6  months 120  to  130 

6  months  to  1  year  .  .' 120 

1  to  2  years 110  to  120 

2  to  4  years 90  to  110 

6  to  10  years 90  to  100 

10  to  14  years 80  to  90 

NUMBER  OF  RESPIRATIONS  PER  MINUTE 

For  the  first  2  or  3  weeks 40 

During  the  first  year 30 

1  to  2  years about  28 

2  to  4  years about  25 

4  to  15  years 20  to  25 


210 


THE    HEALTHY   BABY 


TABLE  OF  POISONS  AND  ANTIDOTES 


POISON 

Acid,  acetic,  hydrochloric, 
sulphuric,  nitric. 


Acid,  carbolic. 
Acid,  oxalic. 

Aconite. 

Alcohol  (brandy,  etc.). 


Alkalies    (as   ammonia, 
lye,  caustic,  potash). 
Ammonia  (see  Alkalies) 
Arsenic    (Fowler's  solu- 
tion,     Paris      green, 
"Rough  on  Rats"). 


Atropine  (see  Belladonna). 
Belladonna  (atropine). 


Blue  vitriol  (see  Copper). 
Carbolic  (see  Acid). 


ANTIDOTES 

An  alkali,  such  as  mag- 
nesia, whiting,  soda,  soap, 
followed  by  soothing 
drinks  or  sweet  oil. 

Epsom  salts  in  abun- 
dance, soap,  no  oil;  for 
external  burns,  alcohol. 

Emetic,  followed  by  lime 
(as  chalk,  plaster,  whit- 
ing) or  magnesia,  but  not 
by  potash  or  soda;  then 
soothing  drinks. 

Emetic,  followed  by  dig- 
italis; no  pillow  under 
head ;  free  stimulation. 

Emetic ;  cold  douche  on 
head;  warmth  and  arti- 
ficial respiration. 

Vinegar  or  lemon  juice, 
followed  by  soothing 
drinks  or  sweet  oil. 

Emetic;  followed  by  a 
fresh  mixture  of  the  tinc- 
ture of  chloride  of  iron 
.with  calcined  magnesia, 
or  baking  soda,  or  water 
of  ammonia;  then  white 
of  egg,  soothing  drinks,  or 
sweet  oil ;  castor  oil  to 
empty  bowels. 

Emetic ;  tannic  acid 
freely;  cold  to  head: 
coffee ;  stimulants  and 
warmth  if  needed. 


LISTS   AND   TABLES 


211 


Caustic  (see  Alkalies). 
Chloral. 

Copper      (blue     stone, 
blue  vitriol,  verdigris). 


Corrosive  sublimate. 


Gas  (illuminating  gas,  coal 


Hydrochloric    acid    (see 

Acid). 
Iodine. 


Laudanum  (see  Opium). 

Lye  (see  Alkalies). 

Matches  (see  Phosphorus). 

Morphine  (see  Opium). 

Nitric  acid  (see  Acid). 

Nux  vomica  (see  Strych- 
nine). 

Opium  (including  lauda- 
num, morphine,  pare- 
goric, soothing  sirups, 
etc.). 


Oxalic  acid  (see  Acid). 
Paregoric  (see  Opium). 
Paris  green  (see  Arse- 
nic). 


Treatment  as  for  opium 
poisoning. 

Emetic,  followed  by 
white  of  egg  or  milk; 
yellow  prussiate  of  potash ; 
then  soothing  drinks. 

Emetic,  followed  by 
white  of  egg  or  milk; 
soothing  drinks;  tannic 
acid  freely ;  castor  oil  to 
open  bowels. 

Fresh  air ;  artificial  res- 
piration; ammonia  to  nos- 
trils; cold  douche. 


Starch  or  flour  mixed 
with  water,  given  freely; 
emetic;  soothing  drinks. 


Emetic  (often  not  effec- 
tive) ;  permanganate  of 
potash  in  doses  of  4  or  5 
grains  if  case  is  seen  early ; 
strong  coffee;  atropine- 
keep  awake  by  cold 
douche  to  head  and  back, 
walking,  and  artificial  res- 
piration. 


212 


THE    HEALTHY    BABY 


Phosphorus  (match- 
heads,  some  roach  and 
rat  poisons). 


Potash  (see  Alkalies). 

Rough  on  Rats  (see  Ar- 
senic). 

Silver  nitrate  (lunar 
caustic). 

Strychnine  (nux  vomica). 
Sulphuric  acid  (see  Acid). 


Emetic;  then  perman- 
ganate of  potash  in  doses 
of  4  or  5  grains  well 
diluted;  Epsom  salts  or 
magnesia  to  open  bowels; 
no  milk  or  oil  of  any  kind. 


Table  salt,  followed  by 
emetic;  milk  or  white  of 
eggs. 

Emetic,  followed  by  tan- 
nic  acid,  bromide  of  pot- 
ash freely,  or  chloral. 


MEMORANDA 
Record  of  Weight  the  First  Year 


213 


Name 


AOE 

DATE 

WEIGHT 

GAIN 

Lbs. 

Oz. 

At 

birth 

1  week 

2  weeks 

3  weeks 

1  month 

4  weeks 

5  weeks 

6  weeks 

7  weeks 

2  months 

8  weeks 

9  weeks 

10  weeks 

11  weeks 

12  weeks 

3  months 

13  weeks 

14  weeks 

15  weeks 

16  weeks 

4  months 

17  weeks 

18  weeks 

19  weeks 

( 

20  weeks 

21  weeks 

5  months 

22  weeks 

23  weeks 

24  weeks 

25  weeks 

6  months 

26  weeks 

214 


MEMORANDA 


Record  of  Weight  the  First  Year  (Continued) 
Name 


AGE 

DATE 

WEIGHT 

GAIN 

Lbs. 

Oz. 

27  weeks 

28  weeks 

29  weeks 

30  weeks 

7  months 

31  weeks 

32  weeks 

33  weeks 

34  weeks 

8  months 

35  weeks 

36  weeks 

37  weeks 

38  weeks 

39  weeks 

9  months 

40  weeks 

41  weeks 

42  weeks 

43  weeks 

10  months 

44  weeks 

45  weeks 

46  weeks 

47  weeks 

11  months 

48  weeks 

49  weeks 

50  weeks 

51  weeks 

12  months 

52  weeks 

MEMORANDA 
Record  of  Weight  after  the  First  Year 


215 


AGE 

DATE 

WEIGHT 
LBS. 

GAIN 

13  months 

14  months 

15  months 

16  months 

17  months 

18  months 

19  months 

20  months 

21  months 

22  months 

23  months 

24  months 

3  years 

4  years 

5  years 

6  years 

7  years 

8  years 

9  years 

10  years 

216  MEMOKANDA 

Record  of  Bottle  Baby's  Food 
Date Age 

oz.  Milk  Quantity  at  Each  Feeding oz. 

oz.  Water  Number  of  Feedings  in  24  hrs 

oz.  Sugar  Intervals  between  Feedings.  _,  .  _  .hrs. 


oz.  Total  quantity  in  24  hrs. 

Bowels 

Number Color Consistency . 

Appetite Sleep Vomiting 


Date 

-oz.  Milk  Quantity  at  Each  Feeding oz. 

_oz.  Water  Number  of  Feedings  in  24  hrs 

_oz.  Sugar  Intervals  between  Feedings hrs. 


oz.  Total  quantity  in  24  hrs. 

Bowels 

Number Color Consistency. 

Appetite Sleep Vomiting 


Date Age 

-oz.  Milk  Quantity  at  Each  Feeding oz. 

-oz.  Water  Number  of  Feedings  in  24  hrs 

-oz.  Sugar  Intervals  between  Feedings hrs. 


oz.  Total  quantity  in  24  hrs. 

Bowels 

Number. Color Consistency. 

Appetite Sleep Vomiting 


MEMORANDA  217 

Record  of  Bottle  Baby's  Food 
Date Age 

oz.  Milk  Quantity  at  E  ach  Feeding oz. 

oz.  Water  Number  of  Feedings  in  24  hrs 

. .  -oz.  Sugar  Intervals  between  Feedings hrs. 


oz.  Total  quantity  in  24  hrs. 

Bowels 

Number Color Consistency. 

Appetite Sleep Vomiting 


Date Age 

_oz.  Milk  Quantity  at  Each  Feeding oz. 

_oz.  Water  Number  of  Feedings  in  24  hrs 

-oz.  Sugar  Intervals  between  Feedings hrs. 


oz.  Total  quantity  in  24  hrs. 

Bowels 

Number Color Consistency. 

Appetite Sleep Vomiting 


Date Age 

-oz.  Milk  Quantity  at  Each  Feeding oz. 

-oz.  Water  Number  of  Feedings  in  24  hrs 

-oz.  Sugar  Intervals  between  Feedings hrs. 


oz.  Total  quantity  in  24  hrs. 

Bowels 

Number Color. Consistency. 

Appetite Sleep Vomiting 


218  MEMORANDA 


MEMORANDA  219 


220  MEMORANDA 

Held  Head  erect  Date Age 

Date Age 

Date Age 

Walked  with  ^Support  Date Age 

Walked  Alone  Date Age 

\ 


MEMORANDA  221 

Record  of  Talking 
First  word,  Notable  sayings,  etc. 


MEMORANDA 

Health  Record 

Nature  of  Illness 
Attending  Physician 


Nature  of  Illness 
Attending  Physician 


Nature  of  Illness 
Attending  Physician 


Nature  of  Illness 
Attending  Physician 


First  Tooth 
2  Lower  Central  Teeth 
2  Upper  Central  Teeth 
2  Upper  Lateral  Teeth 
2  Lower  Lateral  Teeth 
2  Upper  Double  Teeth 
2  Lower  Double  Teeth 

2|  Year-old  Double  Teeth 


MEMORANDA 
Teething  Record 

Right    .     _ 

223 

Left 

Right  

Left  

Right 

Left 

Right  

Left  

Right..  

Left 

Right..  _-. 

Left 

(  Upper  Right 

Left 

(  Lower  Right  . 

Left... 

224  MEMORANDA 


MEMORANDA  225 


226  MEMORANDA 


MEMORANDA  227 


228  MEMORANDA 


INDEX 


Abdomen,  9. 

Abscess  of  breast,  152. 

of  ear,  133. 
Accidents,  101. 
Adenoids,  121. 

cause  of,  122. 

cause  of  bed-wetting,  109. 

in  infancy,  124. 

symptoms  of,  123. 
Airing,  55. 

indoors,  56. 

of  sick  room,  79. 
Alcohol  bath,  91. 
Anger  in  discipline,  64. 
Angry  cry,  17. 

Antidotes  for  poison,  108,  210. 
Antitoxin,  84. 
Anti-vaccinationists,  86. 
Appetite,  20. 

excessive,  23. 

lack  of,  184. 

loss  of,  in  infants,  21. 

loss  of,  in  older  children,  22. 
Awakening  baby  for  food,  12. 

Baby's  basket,  207. 

Baby  carriage,  57-59. 

Baby  comfort,  73,  122. 

Backward  children,  ears  in,  132. 

Backwardness  from  defective 
eyes,  131. 

Bad  air,  53. 

Bananas,  196. 

Band,  41. 

Barley  gruel  in  infant  feed- 
ing, 172. 

Bath,  49. 


in  fever,  52-91. 

temperature  of,  51. 

thermometer,  51. 

time  of,  52. 

tub,  49. 

when  omitted,  52. 
Beans  in  nose,  104. 
Bed,  the,  16. 
Bed-wetting,  73,  109. 

causes  of,  109. 

punishment  for,  112. 

treatment  of,  111. 
Belly,  9. 
Belly-band,  41. 
Berries,  195. 
Blankets,  41,  45. 
Bleeding  from    nose,  103. 

from  wounds,  102. 
Blindness,  cause  of,  130. 
Body,  development  of  the,  8. 
Boiled  milk,  167. 

for  traveling,  182. 
Bones,  broken,  103. 
Bonnet,  48. 
Bottles,  162. 

brush,  163. 

care  of,  162,  170. 

cleaning  of,  163. 

cover,  171. 

feeding,  172. 

rack,  163. 

selection  of,  162. 
Bouillon  capsules,  198. 
Bowels,  28. 

habits  of,  30. 

nursing  mother,  150. 

regular  habits  of,  28. 


229 


230 


INDEX 


Bowel  troubles,  cause  of,  166. 
Bread,  190. 

pap,  200. 

Breast  abscess,  152. 
Breasts,  care  of,  152. 
Breast  feeding,  147. 

bottles  in,  152. 

duration  of,  159,  161. 

intervals  of,  154. 

number  of,  155. 
Breast  Milk,  147. 

and  mother's  bowels,  150. 

weaning,  155. 
Broths,  198. 
Bruises,  103. 
Burns,  107, 

Calomel  in  diarrhea,  37. 

in  vomiting,  26. 
Candy,  195. 

cause  of  poor  appetites,  21. 
Cane  sugar,  173. 
Castor  oil  in  diarrhea,  37. 
Cathartics,  abuse  of,  32. 

in  diarrhea,  37. 
Celluloid     gloves     for     finger 

sucking,  74. 
Cereals,  191. 
Certified  milk,  167. 
Chamber    for    evacuation    of 

bowels,  30. 
Chapping,  135. 
Chicken  pox, -86. 
Choking,  105. 
Circumcision,  140. 
Citrate  of  magnesia,  27. 
Clothing,  41,  208. 

for  older  children,  47. 

in  summer,  46. 

restriction  from,  59. 
Coins  swallowed,  106. 
Colds,  53. 

beginning  of  measles,  84. 

cause  of,  87. 

treatment  of,  94. 


Colic,  18,  152. 
Complexion,  135. 
Condensed  Milk,  183. 
Constipation,  31. 

cause  of  bed-wetting,  109. 

fruit  in,  33. 

in  bottle-fed  infants,  31. 

in  breast-fed  infants,  31. 

in  older  children,  32. 

massage  in,  33. 

vegetables  in,  33. 
Consumption,  88. 
Contagion,  81. 
Contagious  diseases,  81. 
Convulsions,  98. 

causes  of,  99. 

genitals  in,  140. 

treatment  of,  100. 
Coughs,  92. 

cause  of,  87. 

nervous,  116. 
Cracked  nipplep,  153. 
Crackers,  190. 
Cream,  172. 
Creeping,  4. 

Cross-eyed  children,  131. 
Croup,  95. 

kettle,  97. 

treatment  of,  96. 
Crying,  17. 
"Crying  it  out,"  16. 

normal  amount  of,  18. 
Curds  in  stools,  29. 
Cuts,  102. 
Cutting  the  hair,  137. 

Daily  routine,  68. 
Deafness  from  adenoids,  122. 
Decayed  teeth,  128. 
Defective  speech,  7. 
Delayed  talking,  6. 
Delayed  teething,  125. 
Delicate  Child,  exercise  for,  61. 

fresh  air  for,  57. 
Dentistry,  importance  of,  129. 


INDEX 


231 


Desserts,  194,  190. 
Development,  3. 
Dextri-Maltose,  173. 
Dextrinized  gruels,  200. 
Diapers,  43. 

the  discarding  of,  6. 

wetting  of,  72. 
Diarrhea,  34. 

from  improper  feeding,  35. 

from  teething,  36. 

treatment  of,  37. 
Diet  after  the  first  year,  183. 

cause  of  bed-wetting,  109. 

cause  of  poor  appetite,  22. 

for  nursing  mother,  149. 

for  sick  children,  197. 

in  bed-wetting,  112. 

in  weaning  period,  185. 

of  first  year,  172. 
•*  one  year  to  14  months,  186. 

at  14  months,  187. 

15  to  18  months,  187. 

18  months  to  2  years,  188. 

older  children,  189. 

school  age,  190. 

the  third  year,  189. 
Diphtheria,  84. 
Discipline,  62. 
Draughts,  17,  53.     . 
Drawers,  45. 
Dress,  the,  43. 
Drinking  cups,  87. 

Ears,  132. 

abscess  of,  133. 

foreign  bodies  in,  104. 

laps,  48. 

protruding,  132. 

washing  of,  132. 
Earache,  133. 

treatment  of,  134. 
Eczema,  136. 

bath  in,  52. 
Eggs,  193. 
Emergency  supplies,  101. 


Emetics,  108. 
Entertaining  the  baby,  8. 
Epilepsy,  98. 
Eruption  of  teeth,  124. 
Eruptions,  82,  135. 
Examination  of  the  throat,  121. 
Exercise,  58. 

for  delicate  child,  61. 
Expectant    mother,    list    for, 

207. 
Eyes,  130. 

care  of,  130. 

foreign  bodies  in,  106. 

routine  examination  of,  131. 

Fat  babies,  9. 
Feeding,  172. 

breast,  147. 

formulas,  176. 

for  newborn  baby,  178. 

for  traveling,  182. 

gruel  in,  172. 

intervals  of,  69,  175. 

number  of,  155,  174,  176. 

of  sick  babies,  180. 

quantity  of,  177. 

record  of,  216. 

sugar  in,  173. 

tabulated  scheme  for,  176. 
Fever,  90. 

bath  in,  52. 

treatment  of,  91. 
Finger  sucking,  73. 
Fire  escape,  airing  on,  69. 
First  teeth,  124. 
Fly,  the,  88. 
Fontanel,  9. 
Food  for  traveling,  182. 

monotony  of,  23. 
Forcing,  3. 
Foreign  bodies,  in  ear,  104. 

in  eye,  106. 

in  nose,  104. 

in  throat,  105. 

swallowed,  106. 


232 


INDEX 


Foreskin,  140. 
Formulas,  feeding,  176. 
Fractures,  103. 
Fresh  air,  53. 

at  night,  17. 

for  delicate  child,  57. 
Fretful  babies,  62,  70. 
Fretful  children,  20. 
Fretful  cry,  17. 
Fruits,  188,  195. 

in  constipation,  33. 

uncooked,  196. 

Gain  in  weight,  10. 
Genital  organs,  139. 
German  measles,  86. 
Gruels,  198. 

dextrinized,  200. 

in  infant  feeding,  172. 
Gums,  care  of,  128. 

in  teething,  126. 

lancing  of,  127. 
Gymnasium  work,  61. 

Habits,  71. 

of  crying,  19. 

spasms,  115. 
Hair,  137. 

cutting  of,  137. 
Handling  in  babyhood,  62. 
Happiness,  68. 
Hardening,  48. 

process,  92. 
Head,  8. 

Headache  from  eyes,  131. 
Health  record,  222. 
Height,  8. 

table  of,  208. 
Hemorrhage,  102. 
Hoarse  cry,  18. 
Hot     bath     in     convulsions, 

101. 
Hunger,  17,  18. 

natural,  20. 
Hysteria,  116. 


Ice  cap  in  convulsions,  100. 
Imagination,  66. 
Inattention,  123. 
Indigestion,  18. 
Infant  feeding,  172. 
Infection  from  wounds,  102. 
Intervals  of  feeding,  164. 

Jacket,  43. 

Jaw,  deformed,  122, 

Junket,  200. 

Kindergarten,  8. 
Kissing,  87. 
Knitted  band,  42. 

Lancing  the  gums,  127. 

Layette,  208. 

Leggings,  47. 

Length  of  body,  8. 

Lisping,  7. 

List  for  baby's  basket,  207. 

List    for    expectant    mother, 

207. 

Lists,  207. 
Lying,  66. 

Malaria,  88. 

Malt      liquors     for     nursing 

mother,  151. 
Malt  sugar,  173. 
Massage  in  constipation,  33. 
Masturbation,  141. 
Mattress,  17. 
Measles,  83. 
Meat,  193. 

Medicines,  as  poison,  108. 
Memoranda,  of  talking,  221. 

of  events,  220. 

of  weights,  213. 
Menstruation,     milk     supply 

during,  160. 
Mental  development,  7. 
Milk,  165. 
Milk,  bacteria  in,  166. 


INDEX 


233 


Milk,  boiled,  167. 

boiling  of,  179. 

breast,  158. 

cauf=°  of  diarrhea,  34. 

cau_  ,  of  tuberculosis,  90. 

certified,  167. 

condensed,  183. 

crust,  138. 

for  nursing  mother,  151. 

for  sick  children,  197. 

from  herd,  168. 

modification  of,  172. 

pasteurized,  167. 

production  of,  165. 

rule  for  mixing  infants',  174. 

sugar,  173. 

temperature  of,  171. 

too  much,  23. 

Mina,  the  development  of,  7. 
Mixing  of  babies'  foods,  168. 
Modified  milk,  172. 
Moist  air,  93. 
Mosquitoes,  88. 
Mouth  breathing,  121. 
Mouth,  care  of,  50. 
Mucus  in  stools,  29. 
Muffins,  191. 
Mumps,  86. 

Mustard  flour  t     -ause  vomit- 
ing, 109. 
Mustard  foot  bath,  100. 

Nail  biting,  74. 
Naps,  13. 
Navel,  9. 
Nervous  child,  115. 

treatment  of,  117. 
Nervous  cough,  116. 
Nervous  mothers,  149. 
Nervousness,  115. 

genitals  in,  140. 
Newborn  baby,  feeding,  178. 
Night  clothing,  45,  49. 
Night  cry,  18. 
Nightgown,  43. 


Nipples,  care  of,  152,  162. 

selection  of,  162. 

shield,  153. 

soreness  of,  153. 
Nose,  foreign  bodies  in,  104. 
Nosebleed,  103. 

from  adenoids,  123. 
Nursing,  147. 

in  sickness,  80. 

intervals  of,  154. 

mother,  148. 

mother,  diet  for,  149. 

mother,  exercise  for,  148. 

mother,  illness  in,  159. 

Orderliness,  72. 
Outdoor  airing,  55. 
Overdressing,  46. 

Pain  cry,  18. 

Pasteurized  milk,  167. 

Patent  foods,  181. 

Pebbles  in  nose,  104. 

Permanent  teeth,  127. 

Petit  mal,  99. 

Pillow,  17. 

Pimples,  135. 

Pinning  blanket,  42. 

Pinworms,  114. 

Playing  with  baby,  62. 

Poisons,  108,  210. 

Poor     appetites     in     infanta, 

20. 

Poor  sleepers,  15. 
Powder,  common  toilet,  134. 
Prepuce,  140. 
Prickly  heat,  136. 
Prominent  ears,  132. 
Proprietary  foods,  181. 
Protruding  ears,  132. 
Protruding  navel,  9. 
Pulse,  table  of,  209. 
Punishment,  for  bed-wetting, 

112. 
of  children,  65. 


234 


INDEX 


Question  asking,  67. 

Rainy-day  airing,  56. 
Record,  of  feeding,  216. 

of  health,  222. 

of  teething,  223. 

of  weight,  213. 

Rectum,  fissures,  polypi,  pro- 
lapses, 33. 
Regurgitation,  24. 
Respirations,  table  of,  209. 
Restless  sleepers,  15,  17. 
Restless  sleeping,  adenoids  in, 

123. 
Rickets,     cause     of     delayed 

teething,  125. 
Rocking,  16. 
Rompers,  45. 
Routine,  68. 
Rubber  diapers,  44. 
Rubbers,  49. 
Rupture  of  the  navel,  9. 

Safety  pins,  swallowed,  106. 
Scales,  11. 
Scalp,  138. 
Scarlet  fever,  82. 
Schedule  for  the  day,  69. 
School  age,  diet  at,  190. 
School   for   nervous   children, 

117. 

Schools,  inspection  of,  88. 
Schoolrooms,  ventilation  of,  58. 
Scraped  apple,  197. 
Scurvy,  168. 
Second  summer,  36. 
Second  teeth,  127. 
Sedentary  children,  60. 
Shampoo,  the,  137. 
Shield  for  nipples,  153. 
Shirt,  42. 
Shoes,  48. 
Showing  off,  5. 
Sick  room,  79. 
conduct,  80. 


Sitting  alone,  age  of,  4. 
Skin,  134. 
Skirt,  42. 
Sleep,  12. 

for  nervous  children,  .18. 

and  adenoids,  123. 
Sleeping,  out  of  doors,  14,  57. 
Sleeping    room,     temperature 
of,  55. 

ventilation  of,  55. 
Sleeplessness,  13,  15. 
Slip,  the,  43. 
Smallpox,  86. 
Soap  for  bathing,  134. 
Socks,  43,  48. 
Sore  nipples,  153. 
Sore  throats,  95. 
Soups,  194,  198. 
Sour  milk,  166. 
Speech,  6. 

defective,  123. 
Spoiled  children,  20. 
Spoiling  the  baby,  62. 
Sponge,  51. 

Sprays  for  throat,  121. 
Sterilizing  wounds,  102. 
Stockinette  nightgown,  43. 
Stomach,  attacks,  26. 

worms,  \\f 
Stools,  28. 

number  of,  28. 

of  bottle-fed  baby,  29. 

of  breast-fed  baby,  28. 
Story  telling,  66. 
Stuttering,  7. 
Sucking,  73. 
Sugar,  cane,  173. 

for  older  children,  195. 

in  bottle  feeding,  173. 

malt,  173. 

Summer  complaint,  35. 
Summer  teething,  126. 
Supplies  for  accidents,  101. 
Swallowing  of  foreign  bodies, 
105-106. 


INDEX 


235 


Sweets,  195. 

cause  of  a  poor  appetite,  21. 

Table,  of  height,  208. 

of  poisons  and  antidotes,  210. 

of  respirations,  209. 

of  weight,  209. 
Talking,  6. 

memoranda  of,  221. 
Tapeworms,  114. 
Teasing,  66. 
Teeth,  124. 

care  of,  128. 

number  of,  125. 

protruding,  130. 

second,  127. 
Teething,  126. 

and  diarrhea,  36. 

cause  of  convulsions,  99. 

record,  223. 

Temperature   of    bottle   feed- 
ings, 171. 

of  living  rooms,  54. 
Testicles,  undescended,  142. 
Thermometers,  90,  51. 
Thirst  in  sick  infants,  21. 
Threats,  64. 
Throat,  121. 

foreign  bodies  in,  105. 
Tics,  115. 
Toothbrush,  128. 
Top  milks,  172. 
Tonsillitis,  cause  of,  123. 
Tonsils,  121. 

cause  of  enlarged,  122. 
Trained  nurse,  80. 
Training,  62. 

lack  of  in  bed-wetting,  110. 
Truthfulness,  66. 
Tuberculosis,  88. 
Twitching,  115. 

Underclothes,  42. 


Underfed  babies,  19. 
Urine,  retention  of,  142. 

Vaccination,  86. 
Vegetables,  192. 

in  constipation,  33. 
Ventilation,  53,  54. 

of  schoolrooms,  58. 

of  sick  room,  79. 

of  sleeping  room,55. 
Visiting,  5. 
Vomiting,  24, 

from  poisons,  108 

habitual  in  infants,  25. 

of  infants,  24. 

sudden  or  acute,  25. 
Vomitus,  green  or  yellow,  27. 

Walking,  5,  59. 
Walker-Gordon  Milk,  182. 
Water,  147. 

in  diarrhea,  37. 

in  fever,  91. 

in  older  children,  202. 

in  vomiting,  37. 
Weaning,  155. 

diet  in,  185. 

from  bottle,  162. 

reasons  for,  156. 
Weight,  10. 

guide  to  weaning,  156. 

record,  213. 

table  of,  209. 
Wetting,  drawers,  113. 

the  bed,  109. 
Whooping  cough,  85. 
Windows,  17. 

Wine  for  nursing  mother,  151. 
Worms,  113. 

cause  of  bed-wetting,  109. 

common    cause    of    convul- 
sions, 99. 
Wounds,  open,  102. 


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